To the uninitiated, the idea of offering more narcotics to help those suffering from addiction to drugs like heroin or painkillers might sound ludicrous. But that’s exactly what the Yale authors of a new study from the Journal of American Medical Association did for four years at the emergency room of a teaching hospital. What’s more, it worked.

They found that those suffering from opioid dependence were more likely to seek treatment 30 days after an ER visit when they were offered drugs known to ease addiction symptoms than when simply offered a referral or a brief counseling session by the staff. They also self-reported less illicit drug use. Taken as a whole, the researchers believe their results might signal a new approach to how we treat drug addicts who have reached rock bottom.

From 2009 to 2013, the researchers observed 329 volunteers visiting the emergency room who were screened for opioid addiction via urine tests, suffering from an overdose, or openly seeking treatment for their dependence. The participants were then randomly assigned to one of three groups: those given extensive instructions on where to seek in- and out-patient treatment services, those given instructions and a more explicit conversation about their need to seek help, and those given all of the above alongside immediate treatment with buprenorphine (mixed with naloxone), a partial opioid agonist that can decrease symptoms of withdrawal and craving. Though buprenorphine use has been steadily recommended for drug treatment programs, the authors note that there are no such recommendations in place now for people who test positive for narcotics in the emergency room.

Following up with the participants a month later, those given buprenorphine reported about twice as fewer days (0.9) of illicit drug use per week than those in either of the non-buprenorphine groups, though all three reported less use than when they first visited the ER (around five days a week) and the researchers only collected follow-up data from 244 of the original 329 participants. Additionally, the drug treatment group was three times less likely to be attending in-patient treatment, though all three groups reported a similar level of out-patient treatment, “suggesting more efficient, less costly resource use,” the authors wrote.

As the study further points out, those attending the ER are likely already in dire straits, with more than half of their participants having a history of psychiatric treatment, and two-thirds of them having sought out help for their addiction in the past. Similarly, about half reported using needles for their drug fix, leaving themselves open to a myriad of health risks. Any increase of adherence or motivation to attend treatment programs could possibly prevent a worsening spiral down the road.

The authors explain that this study is in fact the very first to compare using buprenorphine in conjunction with referral services to the standard practice of referrals and counseling, cautioning, however, that larger-scale studies will need to be performed in order to determine its effectiveness across different emergency departments.

Still, the authors hope their study will bring about renewed thinking on how best to tackle an increasing rise of ER visits for drug dependence. “Effectively linking ED-initiated buprenorphine treatment to ongoing treatment in primary care represents an exciting new model for engaging patients who are dependent on opioids into state-of-the-art care,” said study author and chief of general internal medicine at Yale School of Medicine Dr. Patrick O’Connor in a press release.