The paramedic role in caring for people who use illicit and controlled drugs: a scoping review

Introduction: As the paramedic profession continues to grow and evolve, a shift from purely reactive to holistic patient care models is required. As the first and often the only point of medical contact for many patients from marginalised and under-served populations, the paramedic role and its potential future implications in caring for these patients need to be explored. 

Aim: The objective of this scoping review was to explore the paramedic's role in caring for people who use illicit and controlled drugs. 

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 illicit and controlled drug 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. The results highlight high rates of mortality following a paramedic-attended drug poisoning event, presenting a unique opportunity for paramedics to approach care in meaningful ways that extend past traditional drug poisoning response. 

Conclusions: The interface between the community of people who use drugs and the paramedic may be a highly influential encounter during a patient's 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.