EMS Clinician Perceptions on Prehospital Buprenorphine Administration Programs

Area of Science:

• Emergency Medicine
• Public Health
• Pharmacology

Background:

• Personal attitudes of emergency medical services (EMS) clinicians can impact the success of prehospital buprenorphine administration programs (PBAPs).
• Limited research exists on EMS clinician perceptions of these innovative programs for opioid use disorder (OUD).

Purpose of the Study:

• To assess EMS clinician perceptions and concerns regarding the implementation of PBAPs.
• To identify potential barriers and facilitators for PBAP adoption within EMS agencies.

Main Methods:

• A mixed-methods study involving focus groups and surveys with 107 EMS clinicians (EMTs, advanced EMTs, paramedics) in South Carolina.
• Thematic analysis was used for open-ended survey responses, supplemented by descriptive statistics for demographic and contextual data.

Main Results:

• Most participants had heard of buprenorphine, but less than a third received education on medication for opioid use disorder (MOUD).
• Key themes included perceptions of opioid withdrawal as non-emergent, concerns about operational impacts, culture shifts, increased substance misuse, and clinician liability.
• Clinician support for PBAP participation was divided, with 45.8% in favor and 44.9% opposed.

Conclusions:

• EMS clinician perceptions significantly influence the potential adoption of PBAPs.
• Findings highlight the need for targeted educational initiatives to address concerns and knowledge gaps regarding buprenorphine in prehospital settings.