Pennsylvania First Responder Addiction and Connection to Treatment Program - In 2020, Pennsylvania (PA) had the fourth highest number of overdose deaths in the United States (n=5,168), and the ninth highest age-adjusted rate of overdose deaths per 100,000 population (https://www.cdc.gov/drugoverdose/deaths/2020.html). PA also saw an increase in the number of drug overdose deaths in 2021 compared to the previous year (n>5,400; https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm). Additionally, Pennsylvanians experienced over 37,000 overdose-related emergency department (ED) visits in 2022, the majority of which are transported to the ED by First Responders; a number which does not capture the number of overdose events that occur where individuals are revived and refuse transport to the ED, nor the individuals that die before reaching the ED (>80% of overdose decedents in 2021). These findings convey the opportunity of First Responders to administer live-saving naloxone and refer patients to resources and treatment. The PA First Responder Addiction and Connection to Treatment Project will provide free training, technical assistance (TA), and tools to Emergency Medical Service (EMS) First Responders to ensure they can provide trauma-informed, evidence-based interventions to patients who are at risk for or have experienced overdose. This project will equip EMS First Responders to administer and leave behind naloxone, educate patients, and facilitate referrals to resources and treatment by way of non-stigmatizing and culturally competent interactions. The population of focus for this project is over 41,000 EMS First Responder professionals serving 13 million residents in PA. The following characteristics of the EMS population of focus were derived from data collected in a previously funded PA EMS First Responder training program from years 2020-2022 (N=2000) which had a similar aim to the proposed project: 95% are White, 1% are Black or African American, 2% are Hispanic or Latino, and 1% are Asian. Further, 100% of the focus population reported speaking English as a first language and the average age range of the workforce is 30-45 years. Additionally, based on national estimates, 8.3% or 13,769 of this workforce identify as LGBTQIA+. The PA Department of Health identified the following goals for this project: 1) Train EMS First Responders on how to treat individuals experiencing or suspected of experiencing overdose in a stigma-free manner, 2) train EMS First Responder agencies to assess readiness to receive naloxone and resource referrals, 3) provide technical assistance to increase knowledge and sustainability of interventions, and 4) develop and execute an inter-disciplinary culturally representative statewide advisory committee. A total of 50 of EMS First Responder agencies and 500 unduplicated individuals will be served annually, resulting in 200 agencies and 2,000 unduplicated individuals to be served throughout the project. Implementation of this project will occur in three phases: (1) Project planning and startup, (2) operations, and (3) project completion. EMS First Responder agencies will be recruited to participate in training to increase knowledge of addiction as a chronic disease, motivational interviewing, compassion fatigue awareness and management, and illicit drug safety. Each agency that completes training will receive three months of TA to assist the agency in implementing and sustaining interventions. By the end of training and TA, EMS First Responders will be able to engage with individuals at risk for overdose and provide evidence-based, trauma-informed, culturally competent, and stigma-free interventions. An advisory committee, that has already been established through previous funding, will meet quarterly throughout the project to oversee implementation, and develop recommendations.
