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

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

American Journal of Public Health, 2015, vol. 105, e26-e32

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.

Keywords: naloxone; narcotic antagonist, adolescent; adult; aged; drug overdose; emergency health service; female; human; male; middle aged; risk factor; rural health care; rural population; United States; very elderly, Adolescent; Adult; Aged; Aged, 80 and over; Drug Overdose; Emergency Medical Services; Female; Humans; Male; Middle Aged; Naloxone; Narcotic Antagonists; Risk Factors; Rural Health Services; Rural Population; United States (search for similar items in EconPapers)
Date: 2015
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Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2014.302520_8

DOI: 10.2105/AJPH.2014.302520

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