A Bridge to Treatment in Louisiana Emergency Departments

Drug overdose in southwest Louisiana

In 2021, CDC data showed that Louisiana’s overdose death rate was the third highest of all states in the country. Fatal overdose rates in Calcasieu Parish, on Louisiana’s southwest border, increased 45% from 2019 to 2020, and in 2021, fatal overdose rates in the Parish increased by 92%, reaching an all-time high.

Health authorities in Calcasieu Parish reviewed opioid fatality data and found that many people who died from an overdose had previously interacted with a hospital, jail, emergency medical services, or other care setting. Most were people who had a documented history of substance use, and many had experienced nonfatal overdoses prior to the fatal overdose.

Adapting the California Bridge program

Given that many people who die from a fatal overdose have interacted with a hospital, emergency departments (EDs) are an important place to identify people at the highest risk of overdose and link them to evidence-based treatment and support. The Region 5 Louisiana Office of Public Health partnered with the Imperial Calcasieu Human Services Authority to launch the Louisiana Bridge Program (LA Bridge), modeled after the nationally recognized California Bridge program, in Southwest Louisiana in late 2021.

The goal of LA Bridge is to save lives by providing 24/7 access to evidence-based treatment for opioid use disorder in the emergency department. The Bridge Program is built on three components:

• Rapid initiation of buprenorphine, an evidence-based treatment, in the emergency department
• Embedding a culture of care into the ED
• Linking people to treatment and services using Substance Use Navigators (SUNs)

SUNs are people with lived experience with substance use and recovery. They are trained as peers and are located within the ED. As the heart of the Bridge program, SUNs serve as patient advocates, establishing trust and providing ongoing links to treatment, community-based prevention services, and overdose education. All overdose patients leave the hospital with lifesaving naloxone.

Southwest Louisiana pilot project

In 2022, Southwest Louisiana implemented their community plan to combat the drug overdose crisis, including the LA Bridge. Overdose deaths in this region decreased by 35% during a time while other nearby regions did not have a decrease or had an increase. The LA Bridge program has since expanded to other hospitals in the region, and 2025 overdose mortality rates show a 43% decline since program implementation and community activation.

From initial implementation in 2022 (the first full project year) to 2024:

• Buprenorphine initiation and/or prescribing from the ED increased by over 300%.
• Naloxone distribution to patients in the ED increased almost 100%.
• Patients linked at ED discharge to a community provider for medications for opioid use disorder increased 400%.

Statewide expansion

After successful pilot implementation, LA Bridge expanded to include a statewide coordinator (through Overdose Data to Action in States) and a technical assistance team, including physician champions, to provide direct support to Louisiana hospitals interested in implementing Bridge programs. The LA Bridge coordinator helps model expansion outside of Southwest Louisiana, informing the development of a statewide framework for expansion, and collaborates with national Bridge to provide 1:1 support to hospitals who are ready to begin Bridge programs. Beginning in February 2026, four hospitals are participating in the first LA Bridge cohort.

LA Bridge addresses multiple challenges in connecting people to resources. Initiating treatment for addiction in the ED provides immediate access to life-saving medication for people at the highest risk of fatal overdose. Using SUNS to connect with patients removes some stigma associated with substance use and fosters trust and respect between people who use substances and the medical community.