This study is about helping people with **opioid use disorder (OUD)** in the **Emergency Department (ED)**. OUD means someone has trouble controlling their opioid drug use. The study will test giving **buprenorphine (BUP)**, a medicine that helps with OUD. They will compare two types: **sublingual buprenorphine (SL-BUP)**, which is taken under the tongue, and **extended-release buprenorphine (XR-BUP)**, which lasts longer in the body. They want to see which one helps more people get into treatment after a week. They will also look at patients with mild or no withdrawal symptoms, using a tool called the **Clinical Opioid Withdrawal Scale (COWS)**. Lastly, they will create new ways to find and track OUD patients using hospital records.

• The study includes about 30 EDs across the U.S.
• Participants must be 18 years or older and meet certain criteria.
• There are risks, like not getting the medicine that works best for you, but the study aims to improve OUD treatment.