Death is the Bottom: Why EMS Must Rethink Opioid Use Disorder Treatment

"Nobody told me that the bottom had a basement and the basement had a trap door." This powerful quote from a grieving mother reveals the tragic reality: for patients with opioid use disorder, rock bottom isn't recovery—it's death.

Dr. Jason Hoppe, a medical toxicologist from the University of Colorado, joins us to challenge how EMS providers think about opioid overdoses. The one-year mortality rate after an overdose requiring Narcan? A staggering 6-7%—worse than the one-year mortality after a STEMI. Yet we invest far less in these patients than cardiac emergencies.

This episode covers the evidence-based treatments that actually work (methadone and buprenorphine have incredibly low numbers-needed-to-treat to save a life), how EMS can initiate life-saving treatment in the field, and why "tough love" and waiting for patients to "hit rock bottom" is a dangerous myth. Learn how just an extra 6-minutes on scene could save lives, why patients on buprenorphine need MORE pain medication during trauma, and how breaking the stigma starts with you.

Ready to make a real difference? Discover how EMS providers are uniquely positioned to interrupt the deadly cycle of opioid use disorder.

Want to build unshakeable confidence on scene? We have developed a program to help paramedics go from self-doubt and imposter syndrome to calm competent providers others look to in crisis. If you want to learn more about our Paramedic Confidence Builder course reach out via email at ross@emspodcast.com or through our contact page at emspodcast.com or via DM on IG @emsloudandclear

Guest/Cast/Crew information-

Guest- Jason Hoppe, D.O.

Hosts - Ross Orpet, Will Berry

Catch up with us after the show

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• Website- www.emspodcast.com