# EMS initiated Buprenorphine for Opioid Use Disorder

> **NIH NIH UG1** · YALE UNIVERSITY · 2024 · $499,472

## Abstract

EMS encounters for opioid overdose and withdrawal have escalated along with the national opioid use
disorder (OUD) crisis. Despite the efficacy of buprenorphine treatment for patients with OUD, and
effectiveness of initiation of buprenorphine in the emergency department (ED) setting, the treatment gap
remains wide. Emergency Medical Services (EMS) is often the first encounter a person with OUD has with the
healthcare system, either after overdose reversal or for treatment for moderate to severe opioid withdrawal.
Unfortunately, some patients refuse transport, or leave against medical advice once they arrive in the ED.
Thus, buprenorphine offered as out-of-hospital emergency care could provide a vital strategy opportunity for
initiation of life saving treatment and referral for ongoing OUD care. Current evidence for EMS initiated
buprenorphine is limited to small retrospective or nonrandomized prospective cohort studies. While promising,
these studies suffer from lack of intervention fidelity, bias, and uncontrolled confounders. EMS-based research
has the potential to expand the reach of ED- and outpatient-based OUD interventions, and significantly
enhance availability of evidence-based addiction care into settings where preventing adverse consequences
of untreated opioid use is critically important. During the 8-month project period, our Specific Aim is to:
Develop a study protocol for prehospital EMS-initiated buprenorphine treatment for patients with OUD
presenting with (a) overdose requiring a naloxone reversal or (b) acute opioid withdrawal to promote
engagement in OUD treatment. Our approach will use a Delphi Consensus Method with a panel of emergency
medicine, EMS, and OUD care content experts. The study protocol will be refined through subsequent focus
groups with EMS personnel and patients with OUD to ensure protocol feasibility and acceptability. Over
subsequent study years we will conduct a sequence of pragmatic controlled field studies to test
implementation of the protocol, followed by a randomized trial to evaluate the effectiveness of EMS delivered
buprenorphine on linkage to addiction treatment.

## Key facts

- **NIH application ID:** 11126377
- **Project number:** 3UG1DA015831-23S1
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Gerard Carroll
- **Activity code:** UG1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $499,472
- **Award type:** 3
- **Project period:** 2002-09-30 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11126377

## Citation

> US National Institutes of Health, RePORTER application 11126377, EMS initiated Buprenorphine for Opioid Use Disorder (3UG1DA015831-23S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/11126377. Licensed CC0.

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