Importance: Co-located bridge clinics aim to facilitate a timely transition to outpatient care for inpatients with opioid use disorder (OUD); however, their effect on hospital length of stay (LOS) and post-discharge outcomes remains unclear.

Question: Does referring inpatients with opioid use disorder (OUD) from a hospital addiction consultation service to a co-located outpatient bridge clinic have an effect on hospital length of stay (LOS) compared with usual care?

Findings: In this randomized clinical trial including 335 patients, with only 88 [26.3%] available for follow-up, bridge clinic referral did not affect hospital LOS. Patients referred to the bridge clinic had more buprenorphine refills, improved linkage to health care professionals who provide medication for OUD, and reduced overdose rates based on 16-week self-report after discharge but reported no significant difference in recurrent opioid use, death rates, or quality of life compared with usual care.

Meaning: Referring inpatients with OUD to a co-located outpatient bridge clinic did not affect hospital LOS.