City of Seattle to become first in nation with fire department EMTs administering buprenorphine medication in the field

Seattle Fire Department expanding its cadre of personnel able to administer buprenorphine in the field to the department's firefighter/EMTs.

Buprenorphine can be given to patients who are being treated for an opiate overdose or to those actively experiencing withdrawal symptoms.

SEATTLE - The Seattle Fire Department (SFD) is expanding its Buprenorphine Pilot Program and Seattle will be the first city in the nation with a program for firefighters/emergency medical technicians (EMTs) to administer the medicine in the field. SFD paramedics began administering the drug earlier this year, and now an initial group of firefighter/EMTs will be trained as well. This will expand the City's capacity to provide this potentially life-saving medicine to patients who are actively experiencing severe opioid withdrawal.

"Providing treatment for people suffering from substance use disorder and addiction is the right thing to do and the smart thing to do. People treated with this highly effective and evidence-backed medication are likelier to agree to follow-up care and conversations, an essential step to breaking the cycle and getting them the help they need," said Mayor Bruce Harrell. "Seattle is a national leader in this space, which is a testament to the expertise and experience of our Fire Department and its members in delivering innovative and exceptional care. Through our comprehensive approach combining public safety and public health, we can make meaningful progress addressing the synthetic opioid crisis and saving lives."

The SFD currently has about 35 paramedics trained to administer the medicine and has begun the process of training the firefighter/EMTs who staff the post-overdose response unit (Health 99) and Health One units. The Washington State Department of Health (DOH) approved the pilot expansion and SFD anticipates around 20 firefighter/EMTs will complete their training in mid-October and be ready to administer the medicine later this month.

"I want to thank the Washington State DOH for moving us forward on this initiative to train more of our personnel to administer this medication to the people we serve. This allows us to continue meeting patients where they are at, versus only providing access to the medication at facilities. Individuals who receive buprenorphine are often more open to discussions about follow-up treatment, and our Health 99 and Health One units are well equipped to navigate those conversations," said Fire Chief Harold Scoggins.

Currently, SFD responds to more than 35 patients per week experiencing an overdose across the City. The department's post-overdose response unit Health 99 has responded to more than 514 overdoses since it launched. Further, in 2023, Public Health - Seattle and King County reported that 735 people died of drug overdoses in Seattle.

"Buprenorphine effectively treats opioid withdrawal. Empowering the EMTs in the Health One program to administer buprenorphine will expand the number of patients with access to this important medication," said SFD's Medical Director Dr. Michael Sayre.

Regular use of buprenorphine has been shown to cut mortality from opioid addiction in half. This medication helps patients recover from the withdrawal effects after an overdose is reversed with naloxone. A single dose of buprenorphine provides 24 to 48 hours of protection from opioid overdose. Relief of withdrawal symptoms provides an opportunity for engaging patients in conversation about treatment, recovery, and social service connections.

SFD's Mobile Integrated Health (MIH) program is partnering with Harborview Medical Center to understand the cascading impact on patients who have received buprenorphine from SFD in the field. The work is being conducted through a grant for a study on a Systems Analysis and Improvement Approach by a University of Washington emergency medicine resident physician, Dr. Kira Gressman.

"SFD paramedics have administered the medicine to 39 patients in the field since the launch of the pilot program. Initial results of the HMC study show that patients who receive this medicine have a higher success rate of scheduling follow-up appointments, receiving medications for opioid use disorder at discharge, obtaining active prescriptions and coordinating follow-up client interaction with our Health 99 unit," said MIH Program Manager Jon Ehrenfeld.

The buprenorphine pilot is supported by additional public health investments in Mayor Harrell's 2025 proposed budget, with $14.5 million specifically dedicated to addressing the opioid crisis. The proposal calls for the City invest $5.7 million to open an Opioid Recovery & Care Access (ORCA) Center and $2.85 million to expand dedicated detox services and inpatient treatment beds at Valley Cities Recovery Place Seattle.

What People Are Saying

Councilmember Robert Kettle, Seattle City Council

"This first-in-the-nation initiative shows that Seattle is serious in its approach to reducing opioid overdoses and providing substance use disorder treatment options. It is incredibly important to have a tandem approach for public safety and public health to the challenges we face in our communities."

Brad Finegood, Strategic Advisor, Public Health - Seattle and King County

"This program is another example of the commitment and innovation taking place across our community to use all the tools we have available to help people struggling with opioid use disorder. By offering buprenorphine following an overdose, first responders are able to help treat withdrawal symptoms while also connecting people to longer-term care options within our community."

Tanya Kim, Director, Human Services Department

"Expanding buprenorphine access to those served by Health One and Health 99 provides another data driven tool to address the devastating overdose crisis and will save lives. Combining these immediate medical treatments with service connections by case managers provide critical opportunities for health interventions, including pathways to treatment."

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