The State Health Commissioner today authorized paramedics to carry buprenorphine to treat acute withdrawal symptoms after patients have been revived from an opioid overdose with Naloxone, the opioid overdose reversal drug.
Commissioner Elnahal signed an Executive Directive today allowing the medical directors of New Jersey’s 21 Mobile Intensive Care Unit (MICU) programs to authorize paramedics to carry buprenorphine, an oral medication used to mitigate what can be severe symptoms of opioid withdrawal after a Naloxone reversal.
The MICU programs can—but are not required to—stock the medication as part of the approved list (formulary) of drugs they can administer.
“Buprenorphine is a critical medication that doesn’t just bring folks into recovery – it can also dampen the devastating effects of opioid withdrawal,” said Health Commissioner Dr. Shereef Elnahal. “That’s why equipping our EMS professionals with this drug is so important.”
The state’s 1,900 paramedics also are not required to carry the drug, but if they do, patients must first be given Naloxone. Before each administration of buprenorphine, paramedics are required to get authorization from their medical command — a physician in a hospital Emergency Department — who oversees the medical care provided by the MICU.
A patient’s insurance will be billed for the administration of buprenorphine as part of the paramedic’s treatment, similar to how patients are billed for care of a diabetic emergency or asthma attack.
A majority of the members of the state’s Mobile Intensive Care Unit Advisory Committee, which represents medical directors from each of the state’s MICUs, voted to endorse the proposal.
The order takes effect immediately. The directive notes that there is an ongoing public health crisis due to opioid use disorders. There were more than 3,000 overdose deaths in New Jersey last year.
Last week, the state made 16,000 free Naloxone kits (32,000 doses) available to the public at pharmacies around the state.
This is not going to be any benefit, this drug in this environment is like adding 1 drop of bleach to a lake. If narcan is administered correctly, patient will not go through a significant withdrawal and will be managed quite well. Most of these patients who overdose and wake often refuse medical care which is allowed under State DOH rules and can not be forced for medical care. More more being offered at a medical expense that is not reimbursed. Lost revenue means more billing and higher costs to all of us.
The only way this will work is if the hospitals actually write prescriptions for this after discharge. However the issue is, once the initial prescription is given, it has to be followwed with rehab and assistance.
This is not going to fix the bigger problem and just an attempt to make it look like the DOH is trying to fix the issue.
Go back to charging these individuals with possession and placing them through Drug court and than being mandated for care and treatment. Not just letting them walk away after being seen in an ED.