Redefining and categorizing emergency medical service opioid‐related incidents in Massachusetts.

Aims: To create a novel emergency medical service (EMS) opioid‐related incident (ORI) tiering framework to describe more accurately the opioid epidemic in Massachusetts. By classifying the data, we could more accurately detail differing trends among the new categories. Design: Free‐text fields of Ma...

Full description

Bibliographic Details
Published in:Addiction Vol. 118; no. 7; pp. 1381 - 1387
Main Authors: Jones, Katarina, Bernson, Dana, Fillo, Katherine T., Bettano, Amy L.
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Jul2023
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=164250347&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 164250347
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        09652140
        AIO
      jtl: Addiction
      issn: 09652140
      maglogo: Y
    pubinfo:
      dt: Jul2023
      vid: 118
      iid: 7
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        164250347
        161782955
        164250347
        164250347
        10.1111/add.16148
        164250347
      ppf: 1381
      ppct: 6
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: C
          – @attributes:
              type: P
      tig:
        atl: Redefining and categorizing emergency medical service opioid‐related incidents in Massachusetts.
      aug:
        au:
          Jones, Katarina
          Bernson, Dana
          Fillo, Katherine T.
          Bettano, Amy L.
        affil: Massachusetts Department of Public Health, Boston Massachusetts, , USA
      sug:
        subj:
          Emergency Medical Services Classification
          Analgesics, Opioid Adverse Effects
          Opioid Epidemic Adverse Effects
          Emergency Medical Services Trends
          Massachusetts
          Human
          Reports
          Severity of Injury
          Signs and Symptoms
          Emergency Medical Technicians
          Physicians, Emergency
          Paramedics
          Algorithms
          Overdose Risk Factors
          Analgesics, Opioid Poisoning
          Death
          Naloxone Administration and Dosage
          Drug Toxicity Drug Therapy
          Overdose Drug Therapy
          Funding Source
      ab: Aims: To create a novel emergency medical service (EMS) opioid‐related incident (ORI) tiering framework to describe more accurately the opioid epidemic in Massachusetts. By classifying the data, we could more accurately detail differing trends among the new categories. Design: Free‐text fields of Massachusetts EMS reports, from 2013 through 2020, were analyzed to identify ORIs and then categorized into a five‐tier severity cascade based on symptom presentation: 'dead on arrival,' 'acute overdose,' 'intoxication,' 'withdrawal' and 'other ORI.' As a validation of the new classification, an emergency medical technician, paramedic and emergency medical physician reviewed clinical reports and assigned a severity category to 100 randomly selected cases. The algorithm then assessed the same 100 cases to determine if it could accurately identify the severity category for each case. Findings Validation of the algorithm by clinical review indicated a substantial level of agreement between the algorithm and the reviewers. Over half of all ORIs were acute overdose (55%), 21% were intoxication, 20% were other ORI, 3% were withdrawal, and 1% were dead on arrival. Overall ORIs decreased in 2020, but the number of 'dead on arrival' increased 32% from 2019. Administration of naloxone also differed between the categories, with 95% of acute overdose and 29% of intoxication receiving naloxone. Conclusions: This novel categorization of emergency medical service opioid‐related incidents in Massachusetts, United States, reveals new trend details and strains on the emergency medical service system. Using these categories also improves dataset linkage within the state and interstate rate comparisons.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N