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Hennepin EMS says paramedics can now give buprenorphine on-scene to help overdose patients into treatment
Summary
Hennepin EMS described a paramedic-driven protocol that allows paramedics to administer buprenorphine for opioid withdrawal on ambulances and a follow-up 'bridge team' that contacts patients after nonfatal overdoses; the program’s first-year tracking shows increased treatment engagement but long-term follow-up remains challenging.
Hennepin County health officials described a new emergency medical services approach Monday that lets paramedics administer buprenorphine on-scene to patients in acute opioid withdrawal and then connect them to follow-up care.
"We go in about six calls a day where naloxone ... is administered," said Tim Coomer, an emergency physician at Hennepin and assistant medical director at Hennepin EMS. "We are the first program in the country to allow our paramedics to do that" — meaning to give buprenorphine under a paramedic-driven protocol without a physician on scene.
Coomer said the county began using the medication after consulting addiction specialists and tracking results closely. He told the board that after a year "the overwhelming majority of patients got better," and that roughly a quarter to a third of patients were still in some form of treatment one month after receiving the intervention, up from near zero before the program.
To improve follow-up, Hennepin EMS created an EMS "bridge team," funded with a state grant, in which specially trained paramedics call patients who received naloxone or buprenorphine. "They just call them and say, how are you doing?" Coomer said. The team also can meet patients in the community and, under Coomer’s license, provide bridge doses when needed.
Commissioners pressed for more data on longer-term outcomes. "How much time are you able to follow-up?" one commissioner asked. Coomer said the population is highly mobile and privacy rules limit tracking beyond about 30 days; much of the month-long follow-up comes from partner organizations reporting deidentified engagement.
Coomer described geographic concentration of overdose calls in Minneapolis but emphasized that the problem occurs across the county. He also flagged sustainability concerns: while putting buprenorphine on ambulances "costs basically nothing," the bridge team is grant-funded and has one year of funding remaining.
Coomer said the county has also worked with the Minnesota Regional Poison Center and launched an online resource (minbridge.org) to share protocols with other EMS systems, including a 24/7 urgent call line to help providers manage patients in withdrawal. He noted that recent state changes allow pharmacists to prescribe short bridge doses, a step he called important for access.
The board applauded the program and recognized EMS personnel in the room. Commissioners said the initiative — which Coomer said has generated positive patient, family and community response — could be a model for other ambulance services if funding and partnerships can be sustained.
The county did not adopt a formal funding commitment at the meeting; commissioners asked for follow-up data and flagged grant sustainability as an issue for future discussion.
