Dallas Fire-Rescue wants its paramedics to do more than revive overdose patients and leave. A program the department calls Bridge to Treatment would have crews screen patients for substance use disorder, offer a dose of buprenorphine on the spot when appropriate, and connect willing patients directly with a treatment provider.
Fire Chief Justin Ball, EMS Deputy Chief Scott Clumpner and Chief Medical Officer Dr. S. Marshal Isaacs are scheduled to brief the City Council's Public Safety Committee on the plan at 1 p.m. Monday, Nov. 9.
The gap the department describes
According to the briefing slides, a paramedic may be the first, and at times the only, person a patient sees at a moment when that person may be most open to help. Yet people revived after an overdose, or found in withdrawal, often leave EMS care without any handoff to a treatment program.
Under the protocol outlined in the presentation, crews would first stabilize the patient, rule out anyone who falls under the program's exclusions, look for signs of opioid use disorder and get consent. A stable patient who agrees could then be given buprenorphine, a medication used to treat opioid addiction, and either taken to a hospital if medically necessary or handed off to a community partner.
The slides list four partners: Parkland Pathways, MetroCare and Homeward Bound for general treatment referrals and assessment, and NEXUS, which takes female patients only and accepts pregnant women. Referral routes would run through the department's Overdose Response Team, the City Detention Center and its MEDIC units.
The department says it will judge the effort by referrals made, overdose survival, fewer repeat overdose calls from the same patients and how many people are successfully linked to treatment. Next steps listed are writing the field buprenorphine protocol, training crews and launching a pilot. The presentation gives no start date or cost.
Vehicles for the crisis team
A related item reaches the full council on Tuesday, Nov. 10. The consent agenda asks members to sign off on an interlocal agreement with the county district attorney's office and accept a $200,000 donation for the city's RIGHT Care program.
