New Study Details Prehospital Buprenorphine Eligibility and Treatment
Contra Costa County Emergency Medical Services (EMS) is one of the largest EMS agencies in the country and among the few to implement a prehospital, first-responder EMS model for treating patients with opioid use disorder (OUD). Under this model, buprenorphine or other medications for opioid use disorder (MOUD) are offered to EMS patients before transport to an emergency department. This innovative model, championed by EMS Bridge, offers communities across the country a promising approach to preventing overdose deaths by engaging first responders as OUD treatment providers.
Research published January 9, 2025 by the EMS Bridge team in the journal “Prehospital Emergency Care” examined 1,159 patient records from Contra Costa County to gain insights into patient eligibility and receipt of prehospital buprenorphine. The study found that 15% of patients identified as possible candidates for MOUD were eligible. However, 62% of potentially eligible patients did not receive it.
These data and the patient characteristics detailed in the paper illuminate the fact that many EMS patients who could benefit from MOUD are not receiving it. For instance, patients in a post-overdose scenario are important candidates for MOUD because they are extremely vulnerable to another overdose episode. And yet, many of the patients in the study who were seen by EMS due to an overdose did not receive prehospital MOUD, missing a critical opportunity to access addiction treatment.
While the study demonstrates opportunities to expand prehospital MOUD, it also showcases success: 38% of eligible patients received buprenorphine. This group of patients represents lives saved and the millions of people this EMS intervention can help as it expands across the nation.
» Click here to access the study.
WHY EMS?
EMS is an essential point of access to addiction treatment, especially for patients unable to access care or reluctant to go to the emergency department or other providers. Patients may not have access to clinics or other medical care in their communities, may fear poor treatment due to stigma related to opioid use, or might not have health insurance. Language and cultural barriers can create additional risks or challenges to receiving MOUD. Some communities avoid medical institutions and providers—they may have been disenfranchised by the healthcare system, or they may not trust medical providers due to damaging personal, family, or community history with medicine.
This is why the EMS Bridge model is so important:
We are capitalizing on EMS as an opportunity to reach patients who may otherwise fall through the cracks, offer MOUD in the field, and connect patients to ongoing care.