Warm handoff interventions and mobile medical services are critical tools for healthcare providers and community organizations to use in helping drug overdose survivors start on a path to treatment and recovery.

This website is a resource for stakeholders to use in implementing and enhancing warm handoff programs and mobile medical services across the U.S.

What is a warm handoff?

A warm handoff is the process of transitioning a patient with a substance use disorder from an intercept point, such as an emergency department, to a treatment provider once the patient is stable.1

What are mobile medical services?

Mobile medical services entail the administration of controlled medications for the treatment of opioid use disorder by emergency medical services professionals outside of a fixed medical facility, e.g., in an ambulance or van.

Why are warm handoffs and mobile medical services important?

Warm handoffs and mobile medical services place overdose survivors and other people with substance use disorders on a path to treatment and recovery, and they can decrease the risk of subsequent overdose.

Overdose survivors have a high likelihood of future hospitalization and fatal or near-fatal medical events.2 According to data on privately insured individuals aged 18 to 64, 40% of patients who received hospital care for opioid-related conditions did not receive any follow-up services whatsoever within 30 days of the hospitalization.3 Of those who did receive treatment, only 10.7% received the hospital-recommended combination of both medication and behavioral therapy services.4

What difference can warm handoffs and mobile medical services make?

Warm handoffs and mobile medical services can improve treatment uptake for overdose survivors and increase treatment retention. The results of a 2015 study of people with opioid use disorder treated in emergency departments found that 78% who received buprenorphine medication were still in treatment after the warm handoff intervention. This compared to 45% who received brief interventions from emergency department staff, and 37% who received only referrals for treatment. 5

In addition, a 2017 clinical trial of emergency-department-initiated treatment with buprenorphine plus 10 weeks of continued buprenorphine treatment showed increased engagement in addiction treatment and reduced illicit opioid use during the 2-month interval of continued buprenorphine treatment.6

1. Michael C. Barnes & Daniel C. McClughen, Warm Handoffs: The Duty of and Legal Issues Surrounding Emergency Departments in Reducing the Risk of Subsequent Drug Overdoses, 48 U. Mem. L. Rev. (2019).
2. Kohei Hasegawa, et. al., Epidemiology of Emergency Department Visits for Opioid Overdose: A Population-Based Study, 89 Mayo Clinic Proceedings 462 (2014).
3. U.S. Dep’t of Health & Human Servs., The CBHSQ Report, (Feb. 11, 2016) https://www.samhsa.gov/data/sites/default/files/report_2117/ShortReport-2117.pdf.
4. U.S. Dep’t of Health & Human Servs., The CBHSQ Report, (Feb. 11, 2016) https://www.samhsa.gov/data/sites/default/files/report_2117/ShortReport-2117.pdf.
5. D’Onofrio G, O’Connor PG, Pantalon MV, et al. Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trialJAMA. 2015;313(16):1636-44.
6. D’Onofrio G, Chawarski MC, O’Connor PG, et al. Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After InterventionJ Gen Intern Med. 2017;32(6):660-666.
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Disclaimer: This website is to be used for educational purposes only. The information on this site is not intended to provide legal advice.