By Caitlyn Freeman
The Seattle Times
SEATTLE 鈥� As part of the city鈥檚 larger efforts to address the opioid crisis, the Seattle Fire Department is piloting a program that allows paramedics to administer buprenorphine when responding to overdoses in the field.
Buprenorphine, which lowers a person鈥檚 desire for fentanyl and gives relief for withdrawal symptoms, has long been a key tool in addiction treatment, but its use in emergency services is more recent, with New Jersey pioneering the approach in 2019.
Using the drug in the field after an overdose is reversed with naloxone creates a treatment window for those experiencing opioid use disorder, Mayor Bruce Harrell said.
鈥淭his program will help break the cycle of someone overdosing, receiving Narcan, then [going] right back onto the streets to seek more opioids and feeling again the severe pain of withdrawal,鈥� he said. 鈥淵ou know what happens when they don鈥檛 have an alternative to their symptoms.鈥�
Buprenorphine is effective for up to two days, while naloxone 鈥� also known by the brand name Narcan in a nasal spray form 鈥� only lasts a couple of hours. That gives first responders time to talk to patients about further treatment, help for recovery and social services, according to a city news release.
Harrell also hopes the pilot program will reduce the number of patients who go to the emergency room for overdosing.
Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin. In 2023, the Fire Department responded to an average of 15.4 overdoses daily, Chief Harold Scoggins said. So far, the department is averaging 14.2 overdose responses per day in 2024.
For the pilot, 10 of the department鈥檚 60 paramedics have been trained to administer buprenorphine. The long-term goal is to get all paramedics trained. Since first responders started carrying buprenorphine three weeks ago, eight people have consented to taking the drug, Scoggins said.
The Fire Department spent a little over $400 on the three boxes of buprenorphine needed for the trial period, spokesperson Kristin Hanson wrote in an email. Each box has 30 doses, which equates to $4.46 per dose. She said the average patient needs two doses.
Once a patient is given the drug, the department鈥檚 Health 99 team 鈥� firefighters and case workers dedicated to overdose calls 鈥� steps in to connect patients with services such as treatment centers.
Since it started six months ago, the Health 99 team has helped facilitate 69 鈥渨arm handoffs鈥� of patients to treatment facilities. An evaluation of the team鈥檚 work called for using buprenorphine in the field, according to Jon Ehrenfeld , the manager who oversees the Fire Department鈥檚 Mobile Integrated Health Program.
鈥淕iving this drug in the field dramatically increases the likelihood of our teams being able to engage and successfully follow up with clients to help connect them with recovery services,鈥� he said in a statement.
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