A new federal investment seeks to improve emergency care for individuals with opioid use disorder and strengthen recovery pathways across Dane County.
The Centers for Disease Control and Prevention has awarded $1.6 million to a multidisciplinary team at the University of Wisconsin School of Medicine and Public Health to launch the Wisconsin Opioid Prevention and Treatment Research Network (WI OPTRN). The new initiative aims to reduce overdose deaths by better integrating evidence-based treatment for opioid use disorder (OUD) in the emergency department with reliable pathways to recovery in the community.
Led by Elizabeth Salisbury-Afshar, MD, MPH, professor of family medicine, and Jill Denson, PhD, MSW, APSW, director of the UW–Madison Prevention Research Center, the effort brings together community advocates with clinicians and researchers across multiple departments at UW–Madison. Among the key collaborators is Collin Michels, MD, a UW Health emergency physician and assistant professor in the BerbeeWalsh Department of Emergency Medicine, whose long-standing partnership with Salisbury-Afshar has helped to shape the initiative’s core strategies.
“We are excited to receive this grant in hopes that we can continue to improve the system of care for people with opioid use disorder in Dane County,” Salisbury-Afshar said.
Strengthening a Critical Point in the Care Continuum
Drug overdose is the leading cause of death among Dane County residents ages 18–54, according to Public Health Madison & Dane County. Eighty percent of overdose deaths are linked to opioids, primarily synthetic opioids like fentanyl.
The primary point of contact with the health care system for people experiencing or at high risk for overdose is the emergency department (ED), making it a crucial intervention setting for individuals with OUD and other substance use disorders.
Yet proven practices for the diagnosis and treatment of opioid use disorder, such as initiating buprenorphine — a safe and effective medication for OUD — in the ED and ensuring patients have a clear path to follow-up care, remain unevenly used. Clinicians often report limited experience treating OUD and uncertainty about where to connect patients for ongoing medication and support, according to Salisbury-Afshar.
The Wisconsin Opioid Prevention and Treatment Research Network will implement three strategies to close these gaps:
- Validate an Opioid AI Screener. The team will adapt and validate an artificial intelligence tool previously used in inpatient settings to help ED clinicians identify patients at high risk for OUD and initiate lifesaving treatment.
- Implement EHR Clinical Decision Support. Building on prior work by Salisbury-Afshar and Michels, the team will embed a real-time, step-by-step support tool inside the electronic health record (EHR) to guide clinicians through buprenorphine initiation, management and automatic referral to outpatient care after high-risk patients are identified.
- Strengthen Linkage to Community Care. The initiative will hire and train peer support specialists to help patients with OUD transition from hospital to community care, including by assisting with appointments, transportation and making connections to long-term recovery services.
Additional collaborators include Hanna Barton, PhD, and Brian Patterson, MD, MPH, of Emergency Medicine; Randy Brown, MD, PhD, of Family Medicine and Community Health; and Majid Afshar, MD, MS, of Medicine. The team draws on expertise in emergency and addiction medicine, implementation science, clinical informatics and human-centered systems design in partnership with the Emergency Care Systems Lab.
A Community Advisory Board composed of people with lived experience with opioid use will help shape priorities and provide feedback on outreach efforts, to ensure the initiative’s work continuously reflects real-world needs.
“Our goal is to ensure that every patient who comes through our doors is met with evidence-based treatment and a clear pathway to recovery,” Michels said.
Building on Local Momentum
WI OPTRN builds on a collaboration that began in 2021, when Salisbury-Afshar and Michels secured a seed grant from the Department of Family Medicine and Community Health. Their early work produced an EHR tool to streamline buprenorphine initiation and a nursing education program that improved clinician confidence in caring for patients with OUD in the emergency department.
Their partnership has since moved beyond the hospital. Working with the Madison Fire Department, the team is evaluating prehospital buprenorphine administration — an emerging EMS strategy that begins treatment before a patient arrives in the ED.
“Our ongoing collaboration has been about meeting patients where they are,” Michels said. “Whether that’s in the field with EMS, in the emergency department, or through follow-up care in the community. Each new initiative builds on what we’ve learned together about making evidence-based treatment accessible from the very first point of contact.”
By integrating data-driven tools, clinical innovation and peer-led support, the Wisconsin Opioid Prevention and Treatment Research Network team seeks to build a model of integrative emergency care for opioid use disorder that can be replicated statewide — expanding access to treatment and helping more people find a path to recovery.
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Funding for this project is provided by the U.S. Centers for Disease Control and Prevention and Department of Health and Human Services through the UW–Madison Prevention Research Center Special Interest Project Competitive Supplement (SIP25-006). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.