Disparity in naloxone administration by emergency medical service providers and the burden of drug overdose in US rural communities.

Abstract

OBJECTIVES:

We determined the factors that affect naloxone (Narcan) administration in drug overdoses, including the certification level of emergency medical technicians (EMTs).

METHODS:

In 2012, 42 states contributed all or a portion of their ambulatory data to the National Emergency Medical Services Information System. We used a logistic regression model to measure the association between naloxone administration and emergency medical services certification level, age, gender, geographic location, and patient primary symptom.

RESULTS:

The odds of naloxone administration were much higher among EMT-intermediates than among EMT-basics (adjusted odds ratio [AOR] = 5.4; 95% confidence interval [CI] = 4.5, 6.5). Naloxone use was higher in suburban areas than in urban areas (AOR = 1.41; 95% CI = 1.3, 1.5), followed by rural areas (AOR = 1.23; 95% CI = 1.1, 1.3). Although the odds of naloxone administration were 23% higher in rural areas than in urban areas, the opioid drug overdose rate is 45% higher in rural communities.

CONCLUSIONS:

Naloxone is less often administered by EMT-basics, who are more common in rural areas. In most states, the scope-of-practice model prohibits naloxone administration by basic EMTs. Reducing this barrier could help prevent drug overdose death.

• Authors: Mark Faul, Michael W Dailey, David E Sugerman, Scott M Sasser, Benjamin Levy, Len J Paulozzi
• Journal: American journal of public health (Am J Public Health) Vol. 105 Suppl 3 Pg. e26-32 (Jul 2015) ISSN: 1541-0048 [Electronic] United States
• PMID: 25905856 (Publication Type: Journal Article)

Chemical References

• Narcotic Antagonists
• Naloxone

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Drug Overdose (drug therapy, epidemiology)
• Emergency Medical Services
• Female
• Humans
• Male
• Middle Aged
• Naloxone (administration & dosage)
• Narcotic Antagonists (administration & dosage)
• Risk Factors
• Rural Health Services
• Rural Population
• United States (epidemiology)