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Prehospital Emergency Care Volume 26, 2022 - Issue 6
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Original Contributions

Prehospital Initiation of Buprenorphine Treatment for Opioid Use Disorder by Paramedics

H. Gene HernReceived June 7, 2021 from Emergency Medicine, Alameda Health System – Highland Hospital, Oakland, California (HGH, AAH); Emergency Medical Services, Contra Costa County, Martinez, California(DG, SK); UCLA Center for Behavioral and Addiction Medicine, Los Angeles, California(MK, SS); Public Health Agency, Contra Costa County, Martinez, California(OT). Revision received August 16, 2021; accepted for publication September 1, 2021.Correspondence[email protected]
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David GoldsteinReceived June 7, 2021 from Emergency Medicine, Alameda Health System – Highland Hospital, Oakland, California (HGH, AAH); Emergency Medical Services, Contra Costa County, Martinez, California(DG, SK); UCLA Center for Behavioral and Addiction Medicine, Los Angeles, California(MK, SS); Public Health Agency, Contra Costa County, Martinez, California(OT). Revision received August 16, 2021; accepted for publication September 1, 2021.
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M. KalminReceived June 7, 2021 from Emergency Medicine, Alameda Health System – Highland Hospital, Oakland, California (HGH, AAH); Emergency Medical Services, Contra Costa County, Martinez, California(DG, SK); UCLA Center for Behavioral and Addiction Medicine, Los Angeles, California(MK, SS); Public Health Agency, Contra Costa County, Martinez, California(OT). Revision received August 16, 2021; accepted for publication September 1, 2021.
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S. KidaneReceived June 7, 2021 from Emergency Medicine, Alameda Health System – Highland Hospital, Oakland, California (HGH, AAH); Emergency Medical Services, Contra Costa County, Martinez, California(DG, SK); UCLA Center for Behavioral and Addiction Medicine, Los Angeles, California(MK, SS); Public Health Agency, Contra Costa County, Martinez, California(OT). Revision received August 16, 2021; accepted for publication September 1, 2021.
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S. ShoptawReceived June 7, 2021 from Emergency Medicine, Alameda Health System – Highland Hospital, Oakland, California (HGH, AAH); Emergency Medical Services, Contra Costa County, Martinez, California(DG, SK); UCLA Center for Behavioral and Addiction Medicine, Los Angeles, California(MK, SS); Public Health Agency, Contra Costa County, Martinez, California(OT). Revision received August 16, 2021; accepted for publication September 1, 2021.
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Ori TzvieliReceived June 7, 2021 from Emergency Medicine, Alameda Health System – Highland Hospital, Oakland, California (HGH, AAH); Emergency Medical Services, Contra Costa County, Martinez, California(DG, SK); UCLA Center for Behavioral and Addiction Medicine, Los Angeles, California(MK, SS); Public Health Agency, Contra Costa County, Martinez, California(OT). Revision received August 16, 2021; accepted for publication September 1, 2021.
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Andrew A. HerringReceived June 7, 2021 from Emergency Medicine, Alameda Health System – Highland Hospital, Oakland, California (HGH, AAH); Emergency Medical Services, Contra Costa County, Martinez, California(DG, SK); UCLA Center for Behavioral and Addiction Medicine, Los Angeles, California(MK, SS); Public Health Agency, Contra Costa County, Martinez, California(OT). Revision received August 16, 2021; accepted for publication September 1, 2021.
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Pages 811-817 | Received 07 Jun 2021, Accepted 01 Sep 2021, Published online: 22 Nov 2021
 
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Abstract

Prehospital initiation of buprenorphine treatment for Opioid Use Disorder (OUD) by paramedics is an emerging potential intervention. Many patients who may be at high risk for overdose deaths may never engage in treatment because they frequently refuse transport. Recent data have demonstrated a significant increase in both short and long term mortality following an opioid overdose. We describe 3 preliminary cases with a novel intervention of initiating Buprenorphine in the prehospital setting for symptoms of opioid withdrawal, regardless of etiology. In addition, we describe tracking of long term engagement in additional services as part of an integrated approach to combatting the opioid epidemic through EMS focused interventions.

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