The opiate crisis in America demands an all-hands-on-deck approach, and community paramedicine isn’t shying away. Here are several ways mobile integrated healthcare-community paramedicine (MIH-CP) is helping professionals administer opioid use disorder treatment.
Community paramedics (CPs) can regularly assess patients in their homes. This makes CPs well-positioned to recognize, prevent, and treat opiate use disorder. In many areas, community paramedics ensure that patients are safely taking their pain medication, that people who experience overdoses receive follow-up care, and that all patients are aware of the dangerous patterns of opiate dependence.
We’ll break down these points in more detail, talking about how opiate use disorder happens and the role community paramedicine takes in helping.
The Role Community Paramedicine Has in Reducing Opiate Use Disorder
Let’s lay the foundation for this discussion. Before we can talk about how community paramedicine is working to curtail the rise in opiate use disorder, let’s talk about what this disorder is, why it happens, and why it’s becoming more and more common.
Note: we should mention that, while we’re providing some general ideas below, the causes of opiate use disorder can be very specific to a person. Community paramedicine should seek to understand the individual when working against opiate use disorder or any substance abuse.
Here are several causes of opiate use disorder:
- Beginning with prescription drugs
- Opiates start to impact the person’s life negatively
- Tolerance is built, and there’s a need for larger doses
Let’s look at these reasons in more depth.
Opiate Use Disorder Often Begins with Prescription Medications
Opiate use disorder often begins with prescription medications. Some estimates are that about 45% of people using heroin were first taking prescription medications. That’s a significant number. There are also estimates that up to 19% of people who are taking pain medications will become addicted to them.
There are many situations where people take pain medications without addiction developing, but the negative numbers are too prevalent to be ignored. Carefully managing prescription medications is one of the first places community health teams should focus on when working to reduce opiate dependence.
Community paramedics can help make these patients aware of the potential dangers and guide them to take the safest possible doses of the medications.
Now, let’s talk about definitions.
The Definition of Opiate Use Disorder: Negative Impacts
Society is moving away from terms like “drug addict,” as they often conjure up a single image that paints the problem with a large brush. The truth is that many people who struggle with opiate use disorder are otherwise living normal lives. Of course, negative drug dependence can lead to a serious loss, whether in a job or housing, but that isn’t always the case.
So, what is opiate use disorder? In simplest terms, OUD happens when dependence on opiates begins to have adverse effects on a person’s life. These effects could be as minor as spending too much time thinking about when you’ll have the next dose of a medication, up to the inability to function in social, work, and family situations.
Why is this distinction important? Because many people might think they don’t need help with an opiate use disorder until they’ve reached the advanced stages of the disease. And this is detrimental because – as with any disease – the longer the problem festers, the harder it is to correct.
Community paramedicine programs can help people recognize the early signs of opiate use disorder so they can get help.
Opiate Tolerance During Regular Use
One of the signs that opiate use disorder is taking a dangerous turn is that patients begin to feel that they need more and more of it to achieve the same effect. Some patients can become desperate, turning to illicit drugs to satisfy their need for more potent opiates.
Often, patients will begin asking for increased doses from their physicians. In some cases, the increased doses might be justified – in other cases, the patient may require a new approach to pain management.
Speaking of a new approach, let’s discuss how community paramedicine has made (and continues to make) an impact in helping people with opiate use disorder.
How Community Paramedicine Can Help Patients Struggling with Opiate Use Disorder
We’ve laid out some of the reasons for opiate use disorder, and now that we understand the problem a little better, let’s talk about the role that community paramedicine should take in preventing the spread of OUD in the United States and around the world.
As you’ll see, there are many unique ways community paramedicine has joined the fight against opiate use disorder. Of course, not all these programs will work for all communities – it’s wise to perform a community assessment and think about the specific practices that would be most effective.
Ways community paramedicine can help with opiate use disorder:
- Programs to closely monitor prescription drug use
- Co-responder programs (reducing law enforcement involvement)
- Harm reduction practices
- Providing post-overdose assistance
Now, let’s go ahead and look at these possibilities with a closer eye.
MIH-CP Programs to Closely Monitor Opioid Use Disorder Treatment Methods
While many people will be prescribed some form of opiate for pain, taking any amount of opiate is not without danger. As we saw earlier, the number of people who go on to become addicted to pain medications is variable yet significant. Certain people are more susceptive to opiate dependence than others, and that’s where community paramedicine comes in.
Those who have a poor social structure, concurrent mental health struggles, or a history of drug misuse should be closely monitored when taking prescription opiates. Also, patients who have poor eyesight, memory lapses, or difficulty securing their medications might be more susceptible to opiate dependence.
Regular visits from community paramedics can have positive benefits in all these situations. People undergoing opioid use disorder treatment often benefit from counselling provided by social workers. Community paramedics can verify precisely how much pain medication a patient is taking. Also, community paramedics can watch for signs of dependence and can help the patient find ways to cope with pain (that don’t require higher doses of opiates).
Let’s chat about rehab.
MIH-CP Can Provide Co-Responder and Jail Diversion Programs
When someone is struggling with an opiate use disorder, they can have several fears. One of the big fears is that they are a “drug addict” and a “criminal” and that they could go to jail. These fears lead to guilt, a desire to hide their addiction, and reluctance to seek rehabilitation.
In various parts of the country, co-responder programs have been developed to help people undergo substance abuse treatments. In these programs, the community paramedic and the rehab professional respond to drug-related calls, reducing the need for police involvement. The goal is to allow people to choose rehabilitation, not threaten them with jail or long-term imprisonment.
If you’re curious, you can read this article about jail diversion programs, which looks at this topic in more depth and discusses how community paramedics are making a difference.
Community Paramedicine and Harm Reduction Practices
Another way that some areas have fought against opiate-related deaths is with harm reduction programs. Like jail diversion programs, harm reduction is all about changing the stigma associated with opiate use. Instead of looking at the problem from a legal perspective, harm reduction practices look at the program from a health perspective.
Community paramedicine can implement harm reduction for opiate use disorder by teaching people everywhere about how to use Narcan. They will also educate people on safe needle practices, provide outreach at safe-use sites, and stand ready to admit someone to rehab when they reach out for help.
If you’d like, take some time to read more about harm reduction practices and how community paramedics have had success with these methods.
Providing Opioid Use Disorder Treatment Through PORT
Mobile integrated healthcare-community paramedicine programs also form Post Overdose Response Teams or PORTs. These teams will respond (voluntarily) to an overdose patient about 72 hours after the event.
These programs aim to provide a medical assessment of the patient, reach out with mental health support, and provide a lifeline if the patient wants to go to rehabilitation. These programs have seen some success around the country and will continue to develop.
Now, let’s go over a few final words.
Conclusion: The Ways Mobile Integrated Healthcare-Community Paramedicine Help Opioid Use Disorder Treatment
Opiate Use Disorder (OUD) is a growing monster within the United States. Community paramedicine teams have found themselves at the perfect intersection to help people win the fight against opiate dependence and addiction.
Many community paramedicine programs help monitor for early warning signs of OUD and provide interventions before the disorder spirals out of control. Community paramedicine teams have also supported people in the grips of severe addiction, working on co-responder programs, harm reduction practices, and post-overdose response.
While the opiate crisis is a dark time, the continued rallying of community healthcare to fight this problem provides some rays of light. Contact Julota to discover how their intuitive software program helps MIH-CP teams collaborate with partners and respond to patients with OUD.