By Kiara Doyal, The Seattle Medium
Seattle is set to become the first city in the nation where firefighters and emergency medical technicians (EMTs) can administer buprenorphine in the field, as part of an expansion to the Seattle Fire Department’s (SFD) Buprenorphine Pilot Program. After successfully launching the program with paramedics earlier this year, the initiative now aims to train firefighters and EMTs to provide this potentially life-saving medication to individuals experiencing severe opioid withdrawal. The expansion will significantly increase the city’s ability to deliver critical treatment to those in immediate need.
Buprenorphine is used to help patients recover from opioid withdrawal after an overdose has been reversed with naloxone. It has been shown to reduce mortality from opioid addiction by 50% when used regularly. A single dose of the medication provides 24 to 28 hours of protection from overdose and relief from withdrawal symptoms. This relief also offers a valuable window of opportunity for first responders to engage with patients about treatment, recovery options, and connections to social services.
“This program is another example of the commitment and innovation taking place across our community to help people struggling with opioid use disorder,” said Brad Finegood, Strategic Advisor for Seattle and King County Public Health. “By offering buprenorphine following an overdose, first responders can treat withdrawal symptoms and connect people to longer-term care options within our community.”
Seattle Mayor Bruce Harrell praised the program for its potential to improve public health outcomes.
“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, evidence-backed medication are likelier to agree to follow-up care and conversations—an essential step in breaking the cycle and getting them the help they need,” said 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.”
Seattle City Councilmember Robert Kettle also emphasized the importance of combining public health and public safety in addressing the opioid crisis.
“This first-in-the-nation initiative shows that Seattle is serious about reducing opioid overdoses and providing substance use disorder treatment options,” said Kettle.
Currently, approximately 35 SFD paramedics are trained to administer buprenorphine. The Washington State Department of Health (DOH) approved the expansion of the program, and by mid-October, around 20 additional firefighters and EMTs will complete their training. These personnel will be ready to administer the drug later this month in the field, further broadening access to treatment for those in need. The new trainees include staff from SFD’s post-overdose response units, Health 99 and Health One, both of which play critical roles in responding to opioid-related emergencies across the city.
“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,” said Seattle Fire Chief Harold Scoggins. “This allows us to continue meeting patients where they are, 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.”
Each week, SFD responds to more than 35 patients experiencing opioid overdoses. Since the pilot’s initial launch, the Health 99 unit alone has responded to over 514 overdoses. In 2023, Public Health—Seattle & King County reported that 735 people in the Seattle area died from drug overdoses, a staggering figure that underscores the need for expanded intervention efforts.
SFD’s Medical Director, Dr. Michael Sayre, highlighted the importance of empowering more first responders to administer buprenorphine.
“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 Sayre.
To better understand the impact of buprenorphine on patient outcomes, SFD’s Mobile Integrated Health (MIH) team has partnered with Harborview Medical Center for a study. Led by Dr. Kira Gressman, a University of Washington emergency medicine resident physician, the research is part of a Systems Analysis and Improvement Approach grant aimed at measuring the program’s success. The study has already shown promising results: patients who receive buprenorphine from SFD are more likely to schedule follow-up appointments, receive medication for opioid use disorder at discharge, and maintain active prescriptions.
“SFD paramedics have administered the medication to 39 patients in the field since the launch of the pilot program,” said MIH Program Manager Jon Ehrenfeld. “Initial results from the study show that patients who receive buprenorphine have a higher success rate of scheduling follow-up appointments and coordinating care with our Health 99 unit.”
The buprenorphine pilot is supported by additional public health investments in Mayor Harrell’s proposed 2025 budget. Of the $14.5 million dedicated to addressing the opioid crisis, $5.7 million will go toward opening an Opioid Recovery & Care Access (ORCA) Center, while $2.85 million will be allocated for expanding detox services and inpatient treatment beds at Valley Cities Recovery Place Seattle.
Tanya Kim, Director of the Seattle Human Services Department, expressed her optimism about the potential impact of the program’s expansion.
“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 provides critical opportunities for health interventions, including pathways to treatment,” said Kim.
As Seattle continues to confront the growing opioid crisis, the expansion of the Buprenorphine Pilot Program represents a critical step forward. By equipping more first responders with the tools to administer life-saving medication, the city is reinforcing its commitment to public health, safety, and recovery.
