By providing buprenorphine around the clock to people in crisis — people who may never otherwise seek medical care — these E.R.s are doing their best to ensure a rare opportunity isn’t lost.

“With a single E.R. visit we can provide 24 to 48 hours of withdrawal suppression, as well as suppression of cravings,” said Dr. Andrew Herring, an emergency medicine specialist at Highland who runs the buprenorphine program. “It can be this revelatory moment for people — even in the depth of crisis, in the middle of the night. It shows them there’s a pathway back to feeling normal.”

It usually takes many more steps to get someone started on addiction medicine — if they can find it at all, or have the wherewithal to try. Locating a doctor who prescribes buprenorphine and takes insurance can be impossible in large swaths of the country, and the wait for an initial appointment can stretch for weeks, during which people can easily relapse and overdose.