Annotated Guidance and Recommendations for the Role and Actions of Emergency Medical Services Systems in the Current Opioid and Drug-Related Epidemics

• Published in: The Journal of emergency medicine 2019-08, Vol.57 (2), p.187-194.e1
• Main Authors: Keseg, David P., Augustine, James J., Fowler, Raymond L., Scheppke, Kenneth A., Farcy, David A., Pepe, Paul E.
• Format: Article
• Language: English
• Subjects: carfentanil; drug overdose; EMS; epidemic; fentanyl; heroin; naloxone; opiate; opioid; opioid analog
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2019.04.017

The U.S. and worldwide death toll from opioids and other drugs has accelerated, rivaling all other causes of premature death. Emergency medical services (EMS) now has an evolving role in providing solutions. EMS medical directors from the majority of the largest U.S. cities and global counterparts met to share/compile an inventory of best practices derived from their respective high-volume experiences in jurisdictions with >114 million residents combined. In turn, they created a consensus guideline document for the purposes of information-sharing among themselves and other interested parties. The group concluded that EMS personnel have evolving training needs with respect to new medical care challenges, but they also recommended that agencies have a special place within the collective of those hoping to provide solutions to the public health crisis of addiction and drug-related epidemics. In addition to intervening in real-time overdose events, it was recommended that they partner with other key stakeholders to develop mechanisms to end the repetitive cycle of emergency rescue followed by an almost immediate return to addictive behaviors. EMS providers should be trained to optimally communicate, refer, and direct the affected individuals to appropriate resources that will provide viable and evidence-based pathways directed toward long-term recovery. Beyond a need to update acute medical rescue practices and improved assessment techniques, EMS providers should also learn to optimally communicate, encourage, and even participate in facilitating management continuity for the affected individuals by identifying and using the appropriate resources that will provide viable, evidence-based pathways toward sustained recovery.