Episode 40-Buprenorphine and New Jersey Paramedics: Perfect Together?

The State of New Jersey, in the throes of an enormous opioid epidemic, has unveiled allowing their Mobile Intensive Care Units (Paramedics) to administer buprenorphine as a part of an optional formulary.

What does this mean? Paramedics and EMTs can rescue patients with naloxone, but are we the right avenue to start people toward recovery? Trail-blazing tactics change in a battle we’ve been losing, or just another windmill to tilt at?

We’re going to discuss buprenorphine, what it does, (and doesn’t), how it can be implemented in the field, and what the potential pearls and pitfalls are for clinicians.

It’s a radical idea. But, just maybe, radical is what we need in this fight.

Check out New Jersey Office of EMS:

https://www.state.nj.us/health/ems/

National statistics from the Center for Disease Control:

https://www.cdc.gov/drugoverdose/data/statedeaths.html

New Jersey’s statistics on a county level:

https://www.state.nj.us/health/populationhealth/opioid/opioid_deaths.shtml

Federal summary of the New Jersey situation:

https://www.drugabuse.gov/opioid-summaries-by-state/new-jersey-opioid-summary

Journal of Substance Abuse paper on initiating outpatient buprenorphine in high-risk populations:

https://www.ncbi.nlm.nih.gov/pubmed/31229187

Reuben Strayer is an emergency physician in NYC, and is doing amazing work on this topic. If you get a chance to hear him speak, do it. You can find him on Twitter: @emupdates and on the internet at www.emupdates.com. He also has several podcasts on the SMACC podcast.

https://emupdates.com/helpcard-and-opioid-misuse/