Individual EMS Disposition in the Prehospital Setting to Predict Future Opioid Overdose and Mortality

There have been over 400,000 deaths related to prescription opioids in the US since 1999, with the highest prevalence among individuals age 45-54 years old. However, adults between the ages of 18 and 34 have the highest prevalence of misuse of prescription opioids. With accidental overdoses as a leading cause of death, Marin County is just one community that is heavily impacted by this ongoing epidemic. Statistics related to non-fatal and fatal opioid overdoses are difficult to accurately count due to the differing ways counties may categorize cause of death, diagnoses, and other contributing factors. However, looking at 911 calls gives us a baseline for community-based non-fatal opioid overdoses encountered by Emergency Medical Services (EMS) to further characterize the burden of opioid overdoses. A cross-sectional study was conducted by Marin County’s Health and Human Services using EMS data and death records. This study determined if an individual's disposition from EMS can be used to predict future outcomes for individuals with opioid use disorder. Whether the patient refuses treatment/transport or accepts treatment/transport may allow us to find patterns that will predict outcomes such as experiencing another overdose or being at a higher risk for allcause or overdose mortality. If our findings show that one disposition yields more favorable outcomes for those experiencing a suspect opioid overdose, this could implicate a solution to intervene at the EMS level. Interventions such as providing patients with resources and facilitating treatment for addiction in the prehospital setting could mean that EMS personnel reach more individuals and thus make a larger impact.