Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;78(1):102-108.
doi: 10.1016/j.annemergmed.2021.01.017. Epub 2021 Mar 27.

Legal Authority for Emergency Medical Services to Increase Access to Buprenorphine Treatment for Opioid Use Disorder

Corey S Davis  1 , Derek H Carr  2 , Melody J Glenn  3 , Elizabeth A Samuels  4
Affiliations

Legal Authority for Emergency Medical Services to Increase Access to Buprenorphine Treatment for Opioid Use Disorder

Corey S Davis et al. Ann Emerg Med. 2021 Jul.

Abstract

Treatment with buprenorphine significantly reduces both all-cause and overdose mortality among individuals with opioid use disorder. Offering buprenorphine treatment to individuals who experience a nonfatal opioid overdose represents an opportunity to reduce opioid overdose fatalities. Although some emergency departments (EDs) initiate buprenorphine treatment, many individuals who experience an overdose either refuse transport to the ED or are transported to an ED that does not offer buprenorphine. Emergency medical services (EMS) professionals can help address this treatment gap. In this Concepts article, we describe the federal legal landscape that governs the ability of EMS professionals to administer buprenorphine treatment, and discuss state and local regulatory considerations relevant to this promising and emerging practice.

PubMed Disclaimer

Conflict of interest statement

Conflicts: None.

Figures

Figure 1:
Figure 1:. EMS workflow for buprenorphine administration during acute response.
EMS professionals will begin by screening for eligibility. Ability to administer buprenorphine varies by whether there is a standing order or through patient-specific order by waivered provider. Transportation to another facility or treatment linkage without transport depends on patient condition and local protocols.
Figure 2:
Figure 2:. EMS workflow for buprenorphine administration during non-acute response.
EMS professionals will begin by screening for eligibility. Buprenorphine may be administered through patient-specific order by a waivered provider and EMS to provide treatment linkage as specified by local protocols.
See this image and copyright information in PMC

Comment in

References

    1. Wilson N, Kariisa M, Seth P, Smith Ht, Davis NL. Drug and Opioid-Involved Overdose Deaths - United States, 2017–2018. MMWR Morb Mortal Wkly Rep. 2020;69(11):290–297. - PMC - PubMed
    1. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. In. Rockville, MD2019.
    1. Vivolo-Kantor AM, Seth P, Gladden RM, et al. Vital Signs: Trends in Emergency Department Visits for Suspected Opioid Overdoses - United States, July 2016-September 2017. MMWR Morb Mortal Wkly Rep. 2018;67(9):279–285. - PMC - PubMed
    1. Vivolo-Kantor AM, Hoots B, David F, Gladden RM. Suspected Heroin Overdoses in US Emergency Departments, 2017–2018. Am J Public Health. 2019;109(7):1022–1024. - PMC - PubMed
    1. Vivolo-Kantor AM, Hoots BE, Scholl L, et al. Nonfatal Drug Overdoses Treated in Emergency Departments - United States, 2016–2017. MMWR Morb Mortal Wkly Rep. 2020;69(13):371–376. - PMC - PubMed

Publication types

MeSH terms