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So far, the opioid crisis hasn’t hit California as badly as many Eastern and Midwestern states. But with deadly synthetic fentanyl spreading there, Highland Hospital in Oakland is trying a new way of getting addicted patients into treatment. Those who come to its emergency room in withdrawal or with another medical problem are offered an initial dose of buprenorphine, a medication that staves off withdrawal symptoms and cravings.

A substantial body of research has found that people who take buprenorphine are less likely to die and more likely to stay in treatment.

Highland is trying to plug a gaping hole in a medical system that typically fails to provide treatment on demand, or any evidence-based treatment at all, even as more than two million Americans suffer from opioid addiction. According to the latest estimates, overdoses involving opioids killed nearly 50,000 people last year.

Dr. Andrew Herring, an emergency medicine doctor at Highland, persuaded the California Health Care Foundation to give a small grant last year to Highland and seven other hospitals in Northern California to experiment with dispensing buprenorphine in their emergency rooms. Now the state is spending nearly $700,000 more to expand the concept. It’s part of a broader $78 million effort to set up a “hub and spoke” system meant to expand access to buprenorphine and two other addiction medications, methadone and naltrexone.