Table 1 Published bridge clinic models, examples, United States, 2023
From: Substance use disorder bridge clinics: models, evidence, and future directions
Outpatient, hospital-based | ||||||||
|---|---|---|---|---|---|---|---|---|
Program | Schedule | Setting | Clinical staffing | MOUD | Naloxone | Harm reduction | ID services | Other services |
Faster Paths Boston Medical Center Boston, MA | 7 days 8A-4:30P Scheduled and walk-in access | Primarily in person Audio-only and audio-visual telemedicine visits available | MD or NP RN care manager Patient care coordinators × 2 | Methadone, 72-h rule Buprenorphine, SL Buprenorphine, SQ Naltrexone, PO Naltrexone, IM | Prescribed Dispensed | Distribution of safer consumption supplies including needles, safer snorting and smoking materials, & fentanyl test strips Condom distribution | HIV testing (phlebotomy) HIV testing (rapid POCT) HIV PEP & PrEP HIV treatment HCV testing & treatment STI testing STI treatment (on-site) Vaccines | Medications for AUD, nicotine UD, and stimulant UD (off-label); wound care, incision & drainage; linkage to recovery coaching; outpatient alcohol & benzodiazepine withdrawal management; patient supplies; contraception & EC; referral to PCP and behavioral health |
MGH Bridge Clinic Massachusetts General Hospital Boston, MA | M-F 9A-5P Scheduled and walk-in access | Primarily in person Audio-only and audio-visual telemedicine visits available | MD (internal medicine & psychiatry) Psychologist RN Medical Assistant Social worker Recovery Coach Resource Specialist Patient Service Coordinators × 2 Practice Manager | Buprenorphine, SL Buprenorphine, SQ Naltrexone, PO Naltrexone, IM | Prescribed Dispensed | Distribution of safer consupmtion supplies including needles, safer smoking materials, & fentanyl test strips Condom distribution | HIV testing (phlebotomy) HIV PEP & PrEP HCV testing STI testing STI treatment (on site) Vaccines | Medications for AUD, nicotine UD, and stimulant UD (off-label); wound care, incision & drainage; referral to HIV/HCV treatment; outpatient alcohol withdrawal management; patient supplies; contraception & EC; individual and group support; referral to PCP |
Brigham and Women's Bridge Clinic Brigham and Women's Hospital Boston, MA | M-F 9A-5P Scheduled and walk-in access | Â | MD (internal medicine & addiction psychiatry) Recovery coaches Social workers Resource specialists Medical assistants | Buprenorphine, SL Buprenorphine, SQ Naltrexone, PO Naltrexone, IM | Prescribed | Â | OPAT Other treatment of deep tissue infections related to injection HCV treatment HIV treatment | Addiction psychiatry care; Care for pregnant people; support navigating Department of Children and Families involvement; individual and group peer support |
Harm Reduction & BRidges to Care (HRBR) Oregon Health Sciences University Portland, OR | M-F 10A-7P | Primarily virtual | MD or NP Care transitions coordinator × 2 Peer recovery specialist | Buprenorphine, SL Naltrexone | Prescribed Dispensed | Safer consumption supplies | HIV testing (phlebotomy) HIV PEP & PrEP HCV testing STI testing STI treatment | Medications for AUD, nicotine UD, and stimulant UD (off-label); referral to HCV treatment; referral to PCP |
Outpatient, Health Center-Based | ||||||||
|---|---|---|---|---|---|---|---|---|
Program | Schedule | Setting | Clinical Staffing | MOUD | Naloxone | Harm reduction | ID services | Other services |
Zuckerberg San Francisco General Family Health Center Bridge Clinic University of California San Francisco San Francisco, CA | M-F 1P-5P In-person and tele M, W, F. Tele only Tu, Th. | Primarily in person and audio-only telemedicine Audio-visual telemedicine visits available | MD (including trainees from addiciton medicine fellowship and family medicine residency) Substance use navigator RN's Medical assistants Eligibility workers (shared with primary care program) | Buprenorphine, SL Buprenorphine, SQ Naltrexone, PO Naltrexone, IM | Prescribed Dispensed | Distribution of safer consumption supplies including smoking kits (e.g., including bubbles, foil, straight pipes and accompanying supplies) and injection kits | HIV testing (phlebotomy) HIV PEP & PrEP HCV testing & linkage to treatment STI testing STI treatment (on site) Vaccines HIV PEP & PrEP HCV testing & linkage to treatment STI testing STI treatment (on site) Vaccines | Medications for AUD and stimulant use disorder (off-label); wound care; outpatient alcohol & benzodiazepine withdrawal management; smoking cessation; patient supplies; contraception & EC; linkage to primary care, therapy, contingency management, residential treatment, and inpatient detox |
Emergency department-based | ||||||||
|---|---|---|---|---|---|---|---|---|
Program | Schedule | Setting | Staffing | MOUD | Naloxone | Harm reduction | ID services | Other services |
CA Bridge Emergency Departments, Multiple Institutions California | 24/7 | Integrated into emergency department care Some hospitals provide ED-staffed outpatient clinic hours for follow-up | Existing emergency medicine staff Substance use navigator | Buprenorphine, SL | Prescribed Dispensed | Hospital staff offered training on distribution of safer injection equipment, encouraged to partner with local syringe service programs | Hospital staff offered training on HIV and HCV screening | Â |
Upstate Emergency Opioid Bridge Clinic State University of New York Upstate Medical University Syracuse, NY | Follow-up clinic open twice per week | Patients started on buprenorphine in the ED are seen by ED providers in an outpatient follow-up clinic. Patients can also be referred by non-ED providers | Emergency medicine providers Peer specialists | Buprenorphine, SL | Prescribed | Safer consumption supplies | Referral to community and hospital departments | Medications for other UD; wound care; referral to PCP and other community resources |
Virtual Only | Â | Â | Â | Â | Â | Â | Â | Â |
|---|---|---|---|---|---|---|---|---|
Program | Schedule | Setting | Staffing | MOUD | Naloxone | Harm reduction | ID services | Other Services |
UPMC Medical Toxicology Telemedicine Bridge Clinic University of Pittsburgh Medical Center Pittsburgh, PA | M-F 9A-5P | Audio only and audio-visual telemedicine visits | Emergency medicine providers | Buprenorphine, SL | Prescribed | Referral to local resources | HIV PrEP Referral to local resources | Motivational interviewing; medications for AUD; outpatient alcohol & benzodiazepine withdrawal management; referral to local SUD provider |
NYC Health + Hospitals Virtual Buprenorphine Clinic New York, NY | M-F 9A-5P | Audio only and audio-visual telemedicine visits | Addicition medicine and addiction psychiatry providers | Buprenorphine, SL | Prescribed Home delivery |  |  | Referral to psychiatry & behavioral health; on site pharmacy; no cost medications if uninsured; referral to PCP; mobie phone application support; insurance enrollment |
Rhode Island Buprenorphine Hotline | 24/7 | Audio only | Addiction medicine, emergency medicine, internal medicine, medical toxicology providers | Buprenorphine SL | Prescribed | Â | Â | Community health worker/peer follow-up; services referral; transportation assistance |