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Introduction
The value of EMTs and paramedics in the emergent care of injury and illness is undoubted. The public knows lights, sirens, and help are just a call away. However, EMS providers' unique position in the community also allows these professionals to work ahead of 9-1-1 requests—to stop injury and illness before they occur.
In the background of the current 100-year COVID-19 pandemic, another public health challenge continues—the opioid crisis. EMTs and paramedics already provide an essential safety net to individuals facing opioid use disorder. They act as a quick response to protect individuals at risk of opioid overdose and death through their normal 9-1-1 operations.
However, when communities face an inordinately high public health risk their EMS providers face a call-to-action, given their unique ability to be leveraged beyond their core focus. The opioid epidemic is one of these moments. To that end, the California Paramedic Foundation, in partnership with CVS Health, has created the California Opioid Prevention by EMS (COPE) Project to help drive EMS participation and collaboration in opioid prevention programming.
The COPE Project has two distinct programming arms. The first is the OpioidLAN, a powerful learning and action network that brings together EMS leaders from around the state. The second is the COPE Course, a free online continuing education class for EMTs and Paramedics that reviews the latest trends in the crisis, highlights ideas of harm reduction and provider self-care, and introduces a pragmatic approach to EMS-driven injury and illness prevention programming.
The OpioidLAN
Great ideas and programs should never be siloed. The Opioid Learning and Action Network (OpioidLAN) is a once-a-month meeting where California EMS leaders can learn from experts in the opioid prevention space, hear from implemented programs across California, and share their programming successes or needs.
The OpioidLAN embraces the California Paramedic Foundation's risk stratification and incremental programming framework, called the RAP Toolkit. This approach supports EMS providers taking the appropriate level of public health action for their community's needs, but nothing more. This pragmatic approach to EMS prevention supports EMS's long-term involvement in the public health landscape.
Each OpioidLAN session is a light-weight, 1-hour session scheduled during the lunch hour to keep attendees' schedule impact to a minimum. Learn more about the OpioidLAN, our COPE Project Team that leads the OpioidLAN, and check our upcoming meeting schedule.
The COPE Course
The COPE Course is a free, 2-hour virtual continuing education class for California EMTs and Paramedics. It has three separate sessions, each followed by a short knowledge check.
In the first session, participants are given critical updates on the prevalence of new Fentanyl derivatives, treatment of these potent opioids, and provider safety from toxicology expert Dr. Jacob Lebin.
In the second session, participants will hear from a harm reduction specialist Kristen Marshall and Paramedic Ashley Jardine. Both session leaders share powerful ideas on harm reduction, meeting patients where they are, and thoughts on self-care as the foundation of good patient care.
EMS and prevention expert Dr. Gene Hern shares risk stratification and incremental programming approaches in the opioid prevention space in the third and final session.
Learn more about the COPE Course and register here!
California's Opioid Risk and EMS Response
Contra Costa OUD Pilot
1. Naloxone Distribution
2. Buprenorphine Bridging Treatment
3. Public Health Interface
4. Opioid Receiving Centers
OpioidLAN Meeting Schedule
Session 1: April 1st, 2021 at 12p
Guest Presenter: Roneet Lev, MD, FACEP
Dr. Roneet Lev was the first Chief Medical Officer of the White House Office of National Drug Control Policy (ONDCP). She was charged with providing medical leadership in coordinating drug policy across the federal government. While working on national health policy, she continued her boots on the ground experience of over 25 years as an emergency physician treating the frontline cases of addiction.
Topic: Eliminating Stigma through clinical understanding.
Dr. Roneet Lev will kick off the OpioidLAN with a discussion on stigma and addiction. Have you been annoyed or rolled your eyes to treat yet another homeless drunk or agitated drug addict? Dr. Lev use to be that medical provider. Now she thinks of 'drugs addicts’ as people with a chronic relapsing disease of the brain, and can be my favorite type of patients. Learn about how to eliminate stigma towards addiction with medical education.
Session 2: May 19th, 2021 at 12p
Guest Presenter: Chief Will Mueller
Will Mueller is the Assistant Chief for Colerain Township Fire and EMS Department.
Topic: Colerain Fire and EMS Opioid Quick Response Team
The Colerain Opioid Quick Response Team has been responsible for a dramatic decrease in their region's opioid overdose 9-1-1 incidents and deaths. It stands as a regional and national model for successfully leveraging EMS providers in the ongoing opioid epidemic. Learn about this award winning program and how it can be applied to the California environment.
Session 3: June 11th, 2021 at 12p
Guest Presenter: Dr. Sylvia Verdugo of FirstWatch
FirstWatch is the international leader in EMS data analytics. In the Opioid LAN Session #3, FirstWatch Medical Director Dr. Sylvia Verdugo highlights best practices in EMS data utilization for public health efforts, such as the opioid crisis, and also demonstrates the power of EMS data in those initiatives.
Session 4: July 7th, 2021 at 12p
Guest Presenter: Timothy Seplaki
Tim Seplaki currently serves as the Chief, EMS Data and Technology for the New Jersey Department of Health, Office of Emergency Medical Services (EMS). His responsibilities include the implementation, coordination, and oversight of the electronic Patient Care Reporting and EMS data collection system for New Jersey. Tim also serves as a member of the National Association of EMS Officials (NASEMSO) Data Managers Council and works closely with the New Jersey State Police Drug Monitoring Initiative (DMI); overseeing and coordinating EMS bio-surveillance data of suspected opioid overdose and Naloxone administration. Additionally, Tim speaks nationally on the opioid response and EMS involvement in combating the opioid crisis.
He has been with the New Jersey Department of Health for 17 years and has been involved in EMS for over 25 years. Tim has been a Nationally Registered Paramedic for over 22 years and has worked in the field on the ground as a Mobile Intensive Care Paramedic and in the air as a Flight Paramedic. He is an EMS educator and is adjunct faculty for a local College Paramedic program. He received his Bachelor of Science degree with a concentration in EMS Management from George Washington University and is a Certified Public Manager.
Five Minutes to Help
In late 2019, the New Jersey Office of Emergency Medical Services (in partnership with Rutgers University’s Center for Public Health Workforce Development) rolled out “Five Minutes to Help”. This program aims to break the stigma of Substance Use Disorder (SUD), as well as educate First Responders on the foundations of motivational interviewing and how to apply it to individuals during the critical few minutes after they are treated for a suspected opioid overdose. The program also provides First Responders with recovery resources that available on a local, regional, and statewide level to help educate the patient of available options for help.
Resources
https://njlmn.njlincs.net/
Session 5: August 4, 2021 at 12p
Guest Presenter: Jon Kelley
Jon Kelley is the Director of Operations & Communications for Trinity EMS based out of Lowell, MA. With a rich career in first response and EMS, Jon has worked as an EMT, dispatcher and EMS leadership and is a national expert in EMS technology and systems.
Topic: Trinity EMS Opioid Response
In the Opioid LAN Session #5, Jon Kelley discusses Trinity EMS’ opioid surge protocol. In 2016, Trinity EMS instigated a protocol designed to identify the presence of an overdose surge using real-time response data, initiate the rapid distribution of communications and activate various response teams to distribute narcan, post in strategic locations etc. This powerful concept makes preventative programming highly successful and also more sustainable.
Session 6: September 9, 2021 at 12p
Guest Presenter: Craig Smollin, MD FACMT
Dr. Smollin is a Professor of Emergency Medicine at the University of California, San Francisco. He is the Co-Medical Director of the California Poison Control System, SF Division and the Fellowship Director for the UCSF Medical Toxicology Fellowship Program.
Topic: Poison Control and the Opiate Crisis
In Opioid LAN Session #6, Dr. Smollin discusses trends in opiate use and overdose toxicology based on the annual report data from the American Association of Poison Control Centers National Poison Data System. Dr. Smollin also discusses the California Substance Use Line, which is designed to answer confidential questions about substance use evaluation and management and is available 24/7 for tele-consultation for EMS and other clinicians.
Resources:
National Poison Data System (NPDS) Annual Reports
California Substance Use Line
Session 7: October 5, 2021 at 12p
Guest Presenter: Daniel Ciccarone, MD, MPH
Dr. Ciccarone is a Professor of Family and Community at the University of California, San Francisco. He is the Justine Miner Professor of Addiction Medicine and his research focuses on the economic, anthropological, historical, clinical and public health dimensions of the heroin crisis.
Topic: Poison Control and the Opiate Crisis
In the Opioid LAN Session #7, Dr. Ciccarone discusses the fourth wave of the opioid epidemic, which is growing due to stimulant- and poly-substance related overdoses. This, combined with the lasting effects of the third wave (fentanyl-laced heroin), the rise in co-use of illicit drugs and the increasing rates of drug contamination are leading to an increase in substance-related mortality nationwide.
UPCOMING!
Session 8: November 3rd, 2021 at 12p
The COPE Team
Gene Hern, MD
Dr. Gene Hern is helps lead and facilitate the OpioidLAN portion of the COPE Project. Gene Hern received his MS in Medical Ethics from UC Berkeley in 1994 and his MD from UCSF in 1996. After residency in Emergency Medicine at Highland Hospital in Oakland in 1996. He stayed on as faculty starting in 2000. As a researcher, he has published 49 peer reviewed articles on topics as diverse as racial differences in pre-hospital opiate use to factors in transitions of care to the use of D10 in out of hospital hypoglycemia. His current focus is on quality improvement and pre hospital innovation and care of patients with Opiate Use Disorders.
John Ehrhart
John is a co-founder and Director of the California Paramedic Foundation and leads the COPE Project. John is excited for the regular and structured use of EMS in public health prevention programs. To that end, he has helped develop the ideas of risk stratification and incremental prevention programming as the foundations of EMS prevention plans. He is excited to see the propagation of EMS Prevention throughout California!
Sara Kelly
Sara Kelly is the project coordinator for COPE. Sara has been an EMT for six years, working for a variety of services in both California and Massachusetts. She is currently pursuing her Masters in Public Health at Harvard University with a focus on the intersection of emergency management and public health. Prior to joining CAPF, Sara worked as a research project manager at Stanford Medicine focusing on cost-saving innovations in healthcare and AI applications in healthcare settings.
