This study is testing two types of medicine to help people with opioid use disorder (OUD), a problem where someone can't stop using drugs like heroin or pain pills. The study takes place in Emergency Departments (ED), which are hospital areas for urgent medical issues. One medicine is called sublingual buprenorphine (SL-BUP), a pill that dissolves under the tongue, and the other is extended-release buprenorphine (XR-BUP), a longer-lasting shot. Researchers want to see which medicine helps more people start addiction treatment within 7 days after leaving the ED. They’ll also examine if XR-BUP helps those with mild withdrawal symptoms, using the Clinical Opioid Withdrawal Scale (COWS), a way to measure withdrawal severity. Participants must be 18 or older and meet certain health criteria. They’ll visit the ED and be checked for opioids in their system. Some people can’t join, like those with certain medical conditions or who are pregnant.

• Study involves multiple ED visits and follow-ups.
• No cost for the medicines being tested.
• Participants can’t join if they’re pregnant or in police custody.