Opioid addiction and overdose has been named a national crisis: In 2019, nearly 50,000 people in the United States died from opioid-involved overdoses. The misuse of and addiction to opioids – including prescription pain relievers, heroin and synthetic opioids, such as fentanyl – not only affects public health but also social and economic welfare.
However, a new program launched by Eagle County Paramedic Services in partnership with Eagle Valley Behavioral Health and Vail Health hopes to prevent opioid overdoses and death with the use of naloxone in the home.
Eagle County Paramedic Services (ECPS) operates ambulances using five stations from Gypsum to Vail, with up to 14 ambulances providing 24-7, 365-day coverage. Last year, the paramedic services answered 5,900 calls from Vail Pass to Hanging Lake. ECPS transports people having medical emergencies, conducts community health services to underserved people in Eagle County and also conducts education and training programs.
By distributing naloxone to patients who are abusing or are at risk of abusing opioids, including prescribed opioids after surgery, we’re hoping we can prevent opioid-related deaths from overdose. It’s similar to having public access defibrillators in community spaces to assist people experiencing sudden cardiac arrest.
Opioid overdoses are not as numerous in Eagle County as in metro areas: There have been approximately a dozen overdoses in the past year. However, this new program serves as the driving force for an anti-stigma campaign. Multiple agencies, including groups from law enforcement, mental health resources and the hospital, are joining forces for what is essentially a harm reduction campaign to help reduce the stigma surrounding opioid addiction.
Naloxone as treatment
Research findings suggest that “take-home naloxone supplied to patients in opioid treatment programs may be part of a targeted harm-reduction strategy to reduce negative outcomes associated with opioid overdose in the community.” As a result, these in-home programs have been introduced to communities across the country.
This initiative to provide naloxone to patients is occurring nation-wide. In Colorado, the Colorado Department of Public Health and Environment is spearheading this effort and, through partnership with Vail Health and Eagle Valley Behavioral Health, EC Paramedics is the only EMS service outside of Metro Denver taking part.
We were uniquely suited for this program because, as CPs, we’re already treating patients in the home. The biggest training consideration for us was the patient education piece – teaching our CPs to teach someone else to use naloxone. It’s second nature to us but for a lay person, it’s not as easy as saying, “put this in your nose and squeeze.”
Additionally, we conducted outreach with the EC Paramedics 911 crews. When these crews are dispatched to patients that might benefit from the program, they’re able to provide information to the patient about the program and the CPs to start the road to assistance.
Collaboration with the various partners in the community is crucial for success. A program like this would be difficult for an agency to handle by itself. Each agency brings a unique skill set to the table to create a whole program for the community. It’s extremely important, as is the support of the various organizations.
Opening the door for treatment
Every use of naloxone to treat an opioid overdose is an opportunity for a person with opioid addiction to seek treatment and support.
Because of our roles as community paramedics, we can help patients navigate through treatment options and we have the ability to follow up with patients and support them while they find the right short- or long-term treatment options. If a patient is worried enough about overdosing that they ask for naloxone in the home, it opens the lines of communication, so we help that patient navigate through substance abuse treatment options as well.
In addition to this program, there’s also a push locally and nationally to better educate healthcare providers on prescribing opiates.
As a community, we’re taking this seriously. Ambulances already carry naloxone – our goal here is harm reduction before it gets to the point of needing an ambulance.
Since the program launched at the beginning of March, we’ve distributed five doses of naloxone, which is a bit higher than we expected. But success is measured in people, not numbers.
If there is a single patient that benefits from this, I would call this program a success. If we are able to provide naloxone to one person who survives an overdose and then gets treatment, then that's a success.