Newsletters

POSTED: December 3rd, 2024
POSTED IN: 2024 Quarter 4, EM Pulse - The Official Newsletter of MOCEP,

by Melissa Kroll, MD and Josh Wilson, BA, EMT-B

Faced with the escalating toll of the overdose crisis, Missouri’s Emergency Medical Services and state partners remain committed to finding innovative solutions to alleviate the burden on their communities. In July 2023, the Department of Mental Health of Missouri awarded the University of Missouri St. Louis-Missouri Institute of Mental Health (UMSL-MIMH) funding through the state department’s opioid abatement funds to create the Drug Overdose and Occupational Safety Training + Mobile Buprenorphine Rescue Intervention for Life Saving Encounters (DOTS+MOBILE) project. UMSL-MIMH will be using these funds to support First Responders in their efforts to combat the opioid epidemic. With these funds, 6 EMS agencies across the state will be participating in EMS field administration of Buprenorphine. With guidance from Dr. Gerard Carroll, an EMS and Addiction physician who pioneered this initiative, our pilot program will lead the way in EMS overdose treatment. 

The six EMS agencies partnered with UMSL-MIMH are: 

• Central Jackson County Fire Protection District (Jackson County) 

• Raytown Fire Department (Jackson County) 

• Missouri University EMS (Boone County) 

• Mehlville Fire Protection District (STL County) 

• Christian EMS (STL County) 

• Joachim-Plattin EMS (Jefferson County) 

The six EMS agencies will use two main strategies for improving overdose patient outcomes: 

EMS administration of medication to treat Opioid Use Disorder – The Overdose epidemic has put a large burden on Missouri first responders, and EMS-initiated Buprenorphine provides an effective new tool to help people in crisis. Beginning in March 2024, six EMS agencies across Missouri will begin field administrations of the medication buprenorphine, an FDA-approved medication to treat Opioid Use Disorder, to patients who have just overdosed on opioids. When a patient is revived from an overdose using naloxone, they can often experience painful withdrawal symptoms making refusal of transport and further overdose more likely. Buprenorphine works by blocking and partially activating the opioid receptors, both relieving patients of their withdrawal symptoms and cravings and also reducing the chances of future overdose. 

Increasing EMS referrals to treatment on-scene – Paramedics will also work to connect patients to higher levels of care for Substance Use Disorder. Using the Engaging Patients in Care Coordination (EPICC) Project, the paramedics ensure patients receive assistance from Recovery Coaches – individuals with lived experience with Substance Use Disorder. These Recovery Coaches will partner with the patients to help them obtain medication, housing, and treatment resources, thereby ensuring the long-term health and safety of individuals in crisis. Evidence shows that support from peers such as Recovery Coaches increases treatment retention, decreases criminal justice involvement, and decreases re-hospitalization rates. 

With these two new strategies, UMSL-MIMH hopes to improve the health and safety of those at risk of opioid overdoses and supply first responders with evidence-based knowledge and resources to best serve their communities. 

View the EMS-Initiated Suboxone flyer for more information.