Emergency Departments are increasingly recognized as a unique touchpoint for patient access to treatment for opioid (OUD), although the provision of evidence based treatments for OUD are underutilized. Innovations in formulations and approach to OUD medications for patients who can be safely transitioned to community partners are evolving, as are strategies to implement programs to provide OUD care. This session will review strategies and rationale for initiating buprenorphine in the emergency department including the use of high dose and injectable formulations, and review data from a recently completed nation-wide study of a 7 day injectable formulation. Strategies for implementing and building a program to evidence based OUD care will be reviewed as well.