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

Author

Listed:
  • Faul, M.
  • Dailey, M.W.
  • Sugerman, D.E.
  • Sasser, S.M.
  • Levy, B.
  • Paulozzi, L.J.

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.

Suggested Citation

  • Faul, M. & Dailey, M.W. & Sugerman, D.E. & Sasser, S.M. & Levy, B. & Paulozzi, L.J., 2015. "Disparity in naloxone administration by emergency medical service providers and the burden of drug overdose in US rural communities," American Journal of Public Health, American Public Health Association, vol. 105, pages 26-32.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.302520_8
    DOI: 10.2105/AJPH.2014.302520
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    Citations

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    Cited by:

    1. Jessica Y. Ho, 2017. "The Contribution of Drug Overdose to Educational Gradients in Life Expectancy in the United States, 1992–2011," Demography, Springer;Population Association of America (PAA), vol. 54(3), pages 1175-1202, June.
    2. Hardy, Rose Y. & Chavez, Laura J. & Cronin, Cory E. & Flint, Julia & Franz, Berkeley, 2022. "Programs to address substance use in U.S. children’s hospitals: Untapped potential for expanding community prevention and treatment resources," Children and Youth Services Review, Elsevier, vol. 133(C).
    3. Aspe, "undated". "Strategies Rural Communities Use to Address Substance Misuse among Families in the Child Welfare System (Summary)," Mathematica Policy Research Reports bfce33a3d8a44dbfbc34b096b, Mathematica Policy Research.

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