Opioid use disorder is not an abstract statistic — it’s a human story. In this episode of the EMS One-Stop podcast, Dr. Remle Crowe returns to introduce the “Prehospital Emergency Care” special issue she guest-edited on enhancing prehospital care for patients with opioid use disorder (OUD).
| MORE: How paramedics can open the door to long-term recovery with buprenorphine
Dr. Crowe shares the profoundly personal motivation behind the issue and makes the case for putting data to work in service of compassion, equity and outcomes.
We walk through the issue’s key sections, highlighting practical lessons for EMS leaders and clinicians, including:
- Data-driven approaches and innovations
- Naloxone and EMS-led harm reduction
- Prehospital buprenorphine programs
- Qualitative insights from clinicians and patients
- Programmatic and QI interventions
The through-line: EMS sits at the intersection of public health and patient care; and multidisciplinary, systems-level change is how we save lives.
Memorable quotes
- “I think having that human aspect and understanding that opioid use disorder affects all of us, all walks of life, all people … we really need to work together and use data for good.” — Dr. Remle Crowe
- “It’s fair to say that both professionally we deal with opioid use disorder, and you’re right—there are not many degrees of separation between everybody that’s watching or listening to this and someone who has experienced it.” — Rob Lawrence
- “May these data points not be in vain so that we can improve this and so other families don’t have to experience the same pain.” — Dr. Remle Crowe
- “Here are 30 really strong articles advancing the science on how we can improve pre-hospital care for patients with opioid use disorder.” — Dr. Remle Crowe
- “If you don’t have your data at the table, it makes it really challenging.” — Dr. Remle Crowe
Additional resources
- Enhancing Prehospital Care for Patients with Substance Use Disorder: Prehospital Emergency Care, Volume 29, Issue 4 (2025):
- UCLA Center for Prehospital Care
- Show me the money: How EMS can tap into opioid funding
- 2025 ESO EMS Index: Opioid overdose calls drop to just 1% of all EMS calls
- Breaking barriers: Hennepin EMS leads the way in safely implementing buprenorphine
Episode timeline
00:21 – Dr. Remle Crowe: human stories behind data; honoring lives by using data for good. Dr. Crowe shares personal motivation and the convergence of personal/professional.
02:52 – The resonance of OUD across the profession and public
04:14 – Data and innovations: EMS as public-health sentinel; novel substance identification
06:12 – Naloxone and harm reduction: precipitated withdrawal, titrate to effect, protocol implications
08:16 – Prehospital buprenorphine: scoping review, consensus guidance, protocol variation
10:46 – Qualitative insights: patient and clinician voices; response team barriers/facilitators
12:59 – QI interventions: prehospital improvement framework to reduce OUD mortality
13:39 – Multidisciplinary action: read, test small changes, build on research
14:53 – How to get into research: ESO Research Forums; NAEMSP year-long workshop
16:21 – Current work: evaluating ACS 2021 trauma triage guidelines in the real world
18:03 – Mentoring and research mindset: hypotheses, null results, publishing to reduce bias
21:43 – Myth-busting/value signaling: EMS care associations and policy-minded publishing. Policy data at the table: testimony, expanding datasets to inform legislation.
26:41 – Dedication to Timmy
