Perceptions of a naloxone leave behind program among emergency medical services personnel in Michigan, USA

In 2020, Michigan implemented its first Naloxone Leave-Behind Program for Emergency Medical Service (EMS) field providers. Under the program, EMS field providers leave naloxone kits to individuals aged 15 or older they encounter in the field who have overdosed, who indicate they have a substance use disorder, or exhibit signs of opioid use and/or to bystanders, friends, or family that are present at the encounter.

Most EMS field providers and administrators supported the Michigan NLB program. However, some were concerned about the unintended consequences of leaving behind naloxone, including the potential for recipients to use more drugs or be less likely to seek treatment. Perspectives of NLB program effectiveness were similar between EMS administrators and field providers. Participating administrators’ top-cited barrier to implementation was convincing field providers to leave behind naloxone, while non-participating administrators were concerned with stocking naloxone kits.

Additional engagement and training to address concerns by EMS field providers and administrators about the benefits of the NLB program are needed to expand program participation intensity. Streamlining naloxone procurement and increasing messaging about free access to naloxone for participating in the program may help increase adoption.

Our study summarizes a survey of EMS field providers and administrators that asked about their perceptions of Michigan’s NLB program (e.g., EMS chiefs, other supervisors, and clerical support staff). This analysis aims to improve the NLB program in Michigan and contribute to the general knowledge base of EMS NLB programs. Our findings may also be useful for other US states and countries considering implementing similar programs.