Clark County first responders have a new tool to fight opioid addiction after overdoses

Clark County first responders can now administer a drug to treat opioid use disorder through a statewide pilot program.

The Washington State Department of Health has partnered with counties across the state to launch a program that allows first responders to administer buprenorphine. The drug stabilizes patients experiencing withdrawal, which is common after Narcan administration, and treats long-term opioid use disorder.

“It’s something EMS medics have been talking about for a long time. That’s really the key,” said Clark County EMS Medical Director Marlow Macht. “What we do every day is respond to calls. What’s new about this is that the goal is to administer the first dose of medication, but then create that warm transition to treatment.”

Ridgefield-based Clark-Cowlitz Fire Rescue is the first department in the county to participate in the program, which began Oct. 1.

In administering buprenorphine, first responders will talk with patients about next steps, including options for permanent treatment, recovery, mental health and other social services.

Buprenorphine, which is taken orally, can only be administered by paramedics and requires special training.

Macht said he anticipates the program will expand to more departments in Clark County within the next two months. The region has a total of 300 paramedics and 500 emergency medical technicians.

“The reason we’re starting small is because we want to show that we’re not just giving people a dose,” he said. “We want to work through these small-scale obstacles and develop these pathways to get people into treatment.”

Answering the call

The Clark-Cowlitz Cares team, started by Clark-Cowlitz Fire Rescue, is officially stocked with buprenorphine doses.

The two-person care team includes a paramedic and a mental health specialist who can respond to calls related to overdoses, suicide attempts and other mental health crises.

There are several steps to treating overdose patients, who are often unconscious when first responders arrive.

They begin by administering Narcan, which immediately reverses the effects of an overdose.

But a patient will often begin experiencing intense and painful withdrawal symptoms soon after. This is where buprenorphine comes in. The medication simultaneously helps relieve these symptoms and acts as the first step in the treatment of opioid use disorder.

Cares Team program manager Sam Lewis said the fire department has partnered with Rainier Springs, Ideal Option and Carelon, three addiction and mental health treatment centers in Vancouver, to link patients with treatment options long-term after an overdose.

“We’ve done a lot of groundwork ahead of time to really look at what programs are going to be the best fit for each person we meet, depending on availability, insurance and location,” Lewis said. “It’s really symbiotic with everyone working together. We see better results with people who recover when they start right away.”

Buprenorphine requires long-term use to effectively treat opioid use disorder. But by providing the initial dose, first responders can have more productive and meaningful conversations to make sure a patient gets the help they need, said Deputy Fire Chief Mike Jackson.

“We can free up those initial response resources, the ambulance and the fire engine, to go back into service for other calls, while our team can stay on scene for as long as it takes to connect with a patient ” Jackson said.

national crisis

Clark County is experiencing its highest number of drug overdose deaths in decades, fueled by the production and trafficking of synthetic opioids such as fentanyl and methamphetamine, according to Clark County Public Health.

In 2023, EMS responded to 890 opioid overdoses in Clark County. That year, 160 people died of drug overdoses. Between 2018 and 2023, the opioid crisis killed 9,251 people in Washington.

“The key thing to communicate is that opioid use disorder is a brain disorder. There’s a lot of stigma in society that sees it as a personal weakness, but we wouldn’t tell a diabetic, ‘Don’t take insulin; it’s a personal weakness,” Macht said.

Buprenorphine is just the first step. Addiction recovery works best when combined with therapy and other resources, but it’s not always that easy.

“The illness itself doesn’t want you to be cured,” said mental health professional Shahna Craegan. “It’s not a conversation we can really have if they’ve just had Narcan. Then they get the buprenorphine and they start to feel a little bit better, which builds trust with us as community responders in their space.”

In all, seven Washington counties have joined the pilot program, including King, Clallam, Spokane, Snohomish, San Juan and Whatcom.

The Seattle Fire Department has already given out 39 doses of buprenorphine. Seattle plans to expand the pilot program to include emergency medical technicians, according to a news release from the Washington State Department of Health.

“The Department of Health is committed to helping Washingtonians live healthy and fulfilling lives and to prevent this opioid crisis from stealing those lives from our neighbors, friends and family,” said Health Secretary Umair A. Shah in a press release. “This pilot program will help us achieve that goal and bring critical care closer to the people who need it most.”