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Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions

OBJECTIVE: The opioid epidemic continues to escalate, and out‐of‐hospital emergency medical services (EMS) play a vital role in acute overdose reversal, but could serve a broader role post‐incident for follow‐up, outreach, and referrals. Our objective is to identify the scope and prevalence of commu...

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Autores principales: Champagne‐Langabeer, Tiffany, Bakos‐Block, Christine, Yatsco, Andrea, Langabeer, James R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771755/
https://www.ncbi.nlm.nih.gov/pubmed/33392528
http://dx.doi.org/10.1002/emp2.12208
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author Champagne‐Langabeer, Tiffany
Bakos‐Block, Christine
Yatsco, Andrea
Langabeer, James R.
author_facet Champagne‐Langabeer, Tiffany
Bakos‐Block, Christine
Yatsco, Andrea
Langabeer, James R.
author_sort Champagne‐Langabeer, Tiffany
collection PubMed
description OBJECTIVE: The opioid epidemic continues to escalate, and out‐of‐hospital emergency medical services (EMS) play a vital role in acute overdose reversal, but could serve a broader role post‐incident for follow‐up, outreach, and referrals. Our objective is to identify the scope and prevalence of community‐based, post‐opioid overdose EMS programs across the United States. METHODS: We used a narrative review of prior studies in PubMed and Scopus for the last 20 years (1999–2020) to identify relevant medical literature and a web search to identify gray literature of EMS interventions involving opioids. RESULTS: Out of nearly 22,000 EMS agencies across the United States, we found evidence of only 27 programs published in medical or gray literature involving post‐overdose interventions. They were most commonly found in the north and eastern region of the country. Although most of these programs incorporate harm reduction and education, other more innovative aspects such as linkage to outpatient addiction treatment or peer support services, are much less common. The most comprehensive programs involved combinations of innovative outreach, specialized referrals, integration with police and criminal justice, peer support, and even treatment initiation. CONCLUSIONS: Out‐of‐hospital emergency care has the potential to provide more comprehensive care after drug overdose, but many programs either do not currently have such an intervention in place, or are not disseminating their practices for other agencies to assimilate. EMS protocols and policies that encourage greater adoption of active community paramedicine practices for opioids should be encouraged.
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spelling pubmed-77717552020-12-31 Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions Champagne‐Langabeer, Tiffany Bakos‐Block, Christine Yatsco, Andrea Langabeer, James R. J Am Coll Emerg Physicians Open Emergency Medical Services OBJECTIVE: The opioid epidemic continues to escalate, and out‐of‐hospital emergency medical services (EMS) play a vital role in acute overdose reversal, but could serve a broader role post‐incident for follow‐up, outreach, and referrals. Our objective is to identify the scope and prevalence of community‐based, post‐opioid overdose EMS programs across the United States. METHODS: We used a narrative review of prior studies in PubMed and Scopus for the last 20 years (1999–2020) to identify relevant medical literature and a web search to identify gray literature of EMS interventions involving opioids. RESULTS: Out of nearly 22,000 EMS agencies across the United States, we found evidence of only 27 programs published in medical or gray literature involving post‐overdose interventions. They were most commonly found in the north and eastern region of the country. Although most of these programs incorporate harm reduction and education, other more innovative aspects such as linkage to outpatient addiction treatment or peer support services, are much less common. The most comprehensive programs involved combinations of innovative outreach, specialized referrals, integration with police and criminal justice, peer support, and even treatment initiation. CONCLUSIONS: Out‐of‐hospital emergency care has the potential to provide more comprehensive care after drug overdose, but many programs either do not currently have such an intervention in place, or are not disseminating their practices for other agencies to assimilate. EMS protocols and policies that encourage greater adoption of active community paramedicine practices for opioids should be encouraged. John Wiley and Sons Inc. 2020-08-07 /pmc/articles/PMC7771755/ /pubmed/33392528 http://dx.doi.org/10.1002/emp2.12208 Text en © 2020 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of the American College of Emergency Physicians. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Emergency Medical Services
Champagne‐Langabeer, Tiffany
Bakos‐Block, Christine
Yatsco, Andrea
Langabeer, James R.
Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions
title Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions
title_full Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions
title_fullStr Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions
title_full_unstemmed Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions
title_short Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions
title_sort emergency medical services targeting opioid user disorder: an exploration of current out‐of‐hospital post‐overdose interventions
topic Emergency Medical Services
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771755/
https://www.ncbi.nlm.nih.gov/pubmed/33392528
http://dx.doi.org/10.1002/emp2.12208
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