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2 results

  • Starting a Prehospital Medication for Opioid Use Disorder Program

  • David C. Seaberg, Jamie McKinnon, Lyn Haselton, Doug Gallo, Jason Kolb, Mary Moran, Suman Vellanki, Amy Raubenolt, Erin Simon, Nicholas Jouriles
  • Journal:
    Prehospital and Disaster Medicine , First View
    Published online by Cambridge University Press:
    20 January 2025, pp. 1-4
    • Article
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  • Background:

    Over 2.7 million people have an opioid use disorder (OUD). Opioid-related deaths have steadily increased over the last decade. Although emergency department (ED)-based medication for OUD (MOUD) has been successful in initiating treatment for patients, there still is a need for improved access. This study describes the development of a prehospital MOUD program.

    Methods:

    An interdisciplinary team expanded a MOUD program into the prehospital setting through the local city fire department Quick Response Team (QRT) to identify patients appropriate for MOUD treatment. The QRT consisted of a paramedic, social worker, and police officer. This team visited eligible patients (i.e., history of an opioid overdose and received prehospital care the previous week). The implementation team developed a prehospital MOUD protocol and a two-hour training course for QRT personnel. Implementation also required a signed contract between local hospitals and the fire department. A drug license was necessary for the QRT vehicle to carry buprenorphine/naloxone, and a process to restock the vehicle was created. Pamphlets were created to provide to patients. A clinical algorithm was created for substance use disorder (SUD) care coordinators to provide a transition of care for patients. Metrics to evaluate the program included the number of patients seen, the number enrolled in an MOUD program, and the number of naloxone kits dispensed. Data were entered into iPads designated for the QRT and uploaded into the Research Electronic Data Capture (REDCap) program.

    Results:

    Over the six-month pilot, the QRT made 348 visits. Of these, the QRT successfully contacted 83 individuals, and no individuals elected to be evaluated for new MOUD treatment. Nine fatal opioid overdoses occurred during the study period. A total of 55 naloxone kits were distributed, and all patients received MOUD information pamphlets.

    Conclusions:

    A prehospital MOUD program can be established to expand access to early treatment and continuity of care for patients with OUD. The program was well-received by the local city fire department and QRT. There is a plan to expand the prehospital MOUD program to other local fire departments with QRTs.

  • 7 - The Actual Cost of the Opioid Epidemic

  • from Part II - Recognizing That a Problem Exists
  • Ethan O. Bryson, Icahn School of Medicine at Mount Sinai, New York, Christine E. Boxhorn, Medical College of Wisconsin, Milwaukee
  • Book:
    The Opioid Epidemic
    Published online:
    07 October 2023
    Print publication:
    12 October 2023, pp 77-93

  • Summary

    The economic costs of the opioid epidemic include direct costs, funds that must be allocated for purchase of any and all goods and services above that which we would normally allocate for these items were there no opioid epidemic, and indirect costs arising from the need to treat health complications related to opioid misuse, the loss of worker productivity and the long-term negative impact on the children and dependents of individuals with opioid use disorder. The opioid epidemic has significantly increased the financial burden on the criminal justice system as governments must now cover the costs for increased law enforcement, the judiciary, corrections, probation services, and parole. Medical costs directly related to the treatment ofopioid use disorder include inpatient and outpatient addiction treatment, the costs for methadone, buprenorphine, and naloxone. In this chapter we look at the specific areas in which the opioid epidemic has had a very real, and very negative effect on the world economy.