Treatment with buprenorphine significantly reduces both all-cause and overdose mortality among individuals with opioid use disorder. Although some emergency departments initiate buprenorphine treatment, many individuals who experience an overdose either refuse transport to an emergency department or are transported to one that does not offer buprenorphine. Emergency medical services professionals can help address this treatment gap. This article describes the federal legal landscape that governs the ability of emergency medical services professionals to administer buprenorphine treatment, and discusses state and local regulatory considerations relevant to this promising and emerging practice.
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