Substance Use and the Paramedic Role: a Scoping Review
Introduction: As the paramedic profession continues to grow and evolve, a shift from reactive
to holistic patient care models is required. As the first and often the only point of medical contact
for many patients from marginalized and under-served populations, the paramedic role, and its
potential future implications in caring for these patients needs to be explored. Aim: The
objective of this scoping review was to explore the paramedics role in caring for people who use
Methods: A scoping review of English language literature published since 2002
was conducted using CINAHL, MEDLINE, EMBASE, and Google Scholar. We used a
previously published paramedic search term filter for sensitivity combined with search terms
related to drug-related substance use and addiction. Studies were selected based on relevance to
the research question.
Results: A total of 104 peer-reviewed and 14 grey literature articles were
selected for inclusion. The main finding of this scoping review is the notable lack of evidence
base surrounding the contemporary paramedic role in the care provision of people who use drugs
(PWUD). The results highlight high rates of mortality following a paramedic-attended drug
poisoning event, presenting a unique opportunity for paramedics to intervene in meaningful ways
that extend past traditional drug poisoning response.
Conclusions: The interface between the
community of PWUD and the paramedic may be a highly influential encounter during a patient.
journey through the healthcare system. The evolving role of the paramedic in this encounter
requires focused study and should be viewed as a research priority in response to the ongoing
drug poisoning crisis.
Jen Bolster is an Advanced Care Paramedic and Paramedic Practice Leader within the department of Clinical Governance and Professional Practice at BC Emergency Health Services. She oversees paramedic practice within the Vancouver Coastal region, and her