As EMS workers in Washington, we’re in the field every day knowing we’ll likely respond to an opioid overdose call. With the rise of synthetic opioids like fentanyl, the calls keep coming. In 2024, emergency medical services responses for suspected opioid overdose increased by 39% in Washington.
For years, first responders in Washington have struggled to treat patients with opioid use disorder. We could only administer naloxone, or Narcan, to revive a patient after an overdose and offer transport to the hospital. When patients refused, we had no choice but to drive away, usually leaving the patient in painful opioid withdrawal.
I’ve left a patient many times expecting to see them again later in that same shift, since those who refuse transport will often take more opioids to address the pain of withdrawal and are likely to overdose again. This cycle is exhausting for first responders and deadly for people in active opioid use.
However, we’ve got a powerful new tool that can help break this cycle. Buprenorphine, a medication for opioid use disorder, offers a solution to immediately address the symptoms of opioid withdrawal and help patients treat their addiction and work toward recovery.
Medications like buprenorphine — which is also known as Suboxone — are safe, evidence-based treatments proven to support people who want to reduce or stop opioid use. Buprenorphine reduces cravings, treats withdrawal symptoms and increases the chances of someone staying in recovery. It can also prevent overdose death by 50%.
In 2023, legal restrictions were loosened to prescribe and administer medications for opioid use disorder across the U.S., and we’ve seen them slowly become more accessible in our state. In 2024, the Department of Health launched a pilot program that allowed paramedics to administer buprenorphine in the field. My agency in Snohomish County was part of the pilot, and it was a critical turning point for patients and our team to help break the cycle of opioid overdose.
For some patients, starting this medication can be the first step to changing their lives. Last year, my EMS team in South Snohomish County responded to a typical overdose call. Paramedics, as well as a community health worker trained in substance use and behavioral health, arrived on scene. They revived the patient, and with his permission, administered buprenorphine.
Within minutes, the withdrawal symptoms had eased, and the patient felt good enough to discuss his preferred course of treatment. He agreed to outpatient treatment, and with follow-up support from the community health worker, turned his life around. He secured housing, employment and reunited with his daughters in Boise, where he now lives.
The EMS buprenorphine pilot program was a success across several Washington counties, and now medical program directors across the state are working with DOH to adopt paramedic patient care protocols to administer buprenorphine in the field.
While EMS agencies are always strapped for resources, I see adding buprenorphine administration as worthwhile for any county in Washington. The ability to treat patients with opioid use disorder in the field translates to real benefits.
Administering medication in the field can mean shorter on-scene times and fewer repeat overdose calls. EMS teams can return to service more quickly and respond to other emergencies more efficiently. The more time emergency response teams are freed up from repeat calls, the better equipped we are to serve the community at large.
Medication for opioid use disorder won’t immediately solve the opioid crisis, but it is an important part of the solution. One big barrier is a lack of comfort with these medications in the medical community, including EMS teams. My team needed basic information and training before becoming comfortable talking to patients about these medications.
The health department and the Health Care Authority have developed a new set of resources and tools to help medical providers start the conversation about this medication. Learn more at: ScalaNW.org/MOUD.
