Wake County EMS pilots successful program treating opioid use disorder

Based on results, EMS will continue providing prehospital treatment

paramedic fills a syringe while another paramedic looks on

In 2022, 6.1 million people in the United States struggled with opioid use disorder. In an epidemic of this scale, finding the right treatment resources can be overwhelming. But what if intervention started when the ambulance arrived? That is the question that Wake County EMS sought to answer with their new Medication for Opioid Use Disorder program.

“Wake County EMS saves lives every day, and the Medication for Opioid Use Disorder program is yet another way of doing so,” said Commissioner Cheryl Stallings of the Wake County Board of Commissioners. “Our staff are pioneering an innovative and empathetic solution for people in our community who are affected by the opioid epidemic.”

Buprenorphine is a medication that has recently emerged as a prehospital treatment for opioid use disorder. The drug can prevent a patient from overdosing for about 18–24 hours after receiving a dose, and it also treats withdrawal symptoms. This makes it easier to break the cycle of opioid use. With the MOUD program, Wake County’s Advanced Practice Paramedics are now equipped with buprenorphine.

How it works
When the paramedics arrive at a call that is thought to be related to opioid use, they screen the patient to determine whether they are eligible for buprenorphine. If so, the Advanced Practice Paramedic can administer treatment right then and there.

“I’m very excited that we are able to offer buprenorphine to patients wherever they are,” said Dr. Andrew Godfrey, associate medical director of Wake County EMS. “There’s a lot of stigma surrounding opioid use disorder, but in reality it’s a disease just like high blood pressure or heart disease. Like with other diseases, patients with opioid use disorder can be treated with medication.”

In addition to medication, patients are also referred to an outpatient provider who can assist them with recovery from opioid use disorder. Wake County EMS has partnered with a local non-profit SouthLight, which has been supporting Wake County for the past 50 years.

SouthLight offers a variety of treatment options, including outpatient, community-based care, evening hours and walk-in appointments. SouthLight’s treatment style focuses on a holistic, patient-centered approach by addressing the patient's physical as well as mental well-being.

What’s next
The MOUD program’s initial review period lasted for one year, from July 5, 2023–July 4, 2024. Within that year, 92.4% of encounters with screened patients resulted in buprenorphine induction. Of those encounters, 47.5% resulted in successful follow-up with the outpatient provider, and 11.4% of those remained in treatment at the end of the year-long review period.

These numbers are encouraging Wake County EMS to continue the MOUD program. Next steps for the program include increased screening of patients who may benefit from buprenorphine and continual reassessment and refinement of the treatment.

For more information about the MOUD program, read the study published in Prehospital Emergency Care and indexed on PubMed.

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Press Release