Prehospital Use of Medication-Assisted Treatment for Opioid Use Disorder: A Rapid Review of Implementation Approaches and Outcomes

Edward E Denton,1 Christian Angelo I Ventura2 1Department of Emergency Medicine Behavioral Emergencies Research Laboratory, University of Arkansas for Medical Sciences; Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA; 2Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USACorrespondence: Christian Angelo I Ventura, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Tel +1 (732) 372-2141, Email [email protected]: This study aimed to evaluate the use of prehospital medication-assisted treatment (MAT) administration by Emergency Medical Services for opioid use disorder (OUD) through a review of literature published between 2014– 2024. A search of the NCBI repository using selected keywords returned N=28 results; articles meeting the inclusion criteria (n=13) were reviewed and analyzed. Heterogeneity among studies was assessed using the Chi-squared test and I² statistic. Studies were categorized into two primary domains: implementation and protocols or patient outcomes. Findings suggest that while MAT administration extends on-scene time, it significantly improves patient retention in OUD treatment. However, operational challenges, including geographical disparities in access and racial inequities in retention, limit widespread implementation. This review underscores the consistent safety of prehospital MAT administration, specifically by EMS personnel outside of an emergency department, yet highlights the need for addressing these barriers to optimize its effectiveness as a critical intervention in managing OUD in the prehospital setting.Keywords: opioid-related disorders, medication-assisted treatment, substance withdrawal syndrome, prehospital care, emergency medical services