# Paramedic-Administered Buprenorphine as a Bridge to Medication-Assisted Treatment

> **NIH NIH R21** · PACIFIC INSTITUTE FOR RES AND EVALUATION · 2020 · $196,487

## Abstract

Abstract
Opioid use disorder is considered a chronic and life-threatening condition that affects at least 2.5 million people
in the United. States. To reduce opioid overdose deaths and begin a bridge to treatment among people with
opioid overdose disorder, the Medical Director of Emergency Services of Forsyth County, North Carolina has
just signed a protocol allowing specially trained community paramedics to administer buprenorphine for up to
seven days as a bridge to Medication Assisted Treatment (MAT). The paramedics will offer this medication to
opioid overdose survivors (OOS) beginning immediately following reversal, and without requiring transport to
an emergency department. This cutting edge and innovative preventive intervention is intended to meet OOS
where they are by providing an initial dose of buprenorphine for withdrawal relief and support for MAT initiation.
At present, we do not know whether OOS are willing to begin this regimen at this vulnerable time. Our study’s
purpose is to examine the extent to which OOS consent to accept paramedic-prescribed buprenorphine
administered immediately following reversal. We will also examine whether the presence of a community-
based peer navigator at the scene of an overdose reversal, in addition to a paramedic, increases OOS’
acceptance of buprenorphine. The peer navigator’s role will be to provide support, encouragement, and
education concerning the benefits of buprenorphine as a bridge to MAT. Our study will clarify whether a
buprenorphine regimen as a bridge to MAT can successfully be introduced immediately following a reversal, or
whether the invitation should be delayed, as some believe, until a later time. We will also investigate the
added value of peer navigators as a means to encourage OOS to begin buprenorphine, as well as OOS’
characteristics associated with the acceptance or refusal of the medication. We will analyze community
paramedic data collected at the time of reversal to calculate the proportion of persons who accept
buprenorphine and whether acceptance rates vary by the presence of a peer navigator. This observational
study is time-sensitive as the findings of this unique opportunity will yield invaluable information concerning this
novel strategy to prevent opioid overdoses and facilitate OOS’ entry into MAT.

## Key facts

- **NIH application ID:** 9849236
- **Project number:** 5R21DA048086-02
- **Recipient organization:** PACIFIC INSTITUTE FOR RES AND EVALUATION
- **Principal Investigator:** Martha W Waller
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $196,487
- **Award type:** 5
- **Project period:** 2019-01-15 → 2022-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9849236

## Citation

> US National Institutes of Health, RePORTER application 9849236, Paramedic-Administered Buprenorphine as a Bridge to Medication-Assisted Treatment (5R21DA048086-02). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/9849236. Licensed CC0.

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