Factors related to substance use treatment attendance after peer recovery coach intervention in the emergency department

•The emergency department (ED) is a prime location for substance use intervention.•Peer support may facilitate linkage to treatment, but important factors are unknown.•We used electronic health record data to evaluate patient factors related to linkage.•Medicaid insurance was positively associated with being linked to treatment.•The action stage of change was positively associated with treatment linkage. Brief intervention with peer recovery coach support has been used to generate referrals to substance use disorder treatment from the emergency department (ED). This retrospective study evaluated factors associated with successful linkage to treatment following brief intervention in the ED. Data were extracted from the electronic health record for patients who were referred to substance use treatment from the ED and for whom follow-up data regarding treatment attendance was available (n=666). We examined associations between demographic and insurance variables, substance use, mental health diagnosis, prior abstinence, and stage of change with successful linkage to substance use treatment after ED referral. The sample was majority male (68%), White (62%), and had a mean age of 43 years (SD=12). Medicaid was the most common insurance (49%) followed by employer/private (34%). Multivariable logistic regression determined patients with Medicaid (OR=2.94, 95% CI:2.09-4.13, p=