The Regional Paramedic Program for Eastern Ontario (RPPEO) is supporting paramedic services as they implement the ALS PCS Auxiliary Directive for buprenorphine/naloxone (Suboxone®). This directive is an important step in improving care for patients with opioid use disorder.

Central Resources

To help paramedics and services navigate this change, RPPEO has created a repository of guidance and tools:

• Clinical Bulletin (Revised)
  Updated RPPEO Clinical Bulletin outlining eligibility, dosing, documentation, and harm reduction principles. >>>Read Clinical Bulletin on OUD, Buprenorphine/Naloxone, and Naloxone

• MedicNEWS Articles

  In-depth coverage of Opioid Use Disorder, Suboxone® implementation, and clinical considerations.

  1. “Suboxone Authorization for Paramedics: What You Need to Know” https://sway.cloud.microsoft/YbadDTosQYN8kL9f?ref=Link

  2. “Paramedics on the Front Line of the Opioid Crisis” https://sway.cloud.microsoft/Mb1LtcDiC36dDdnx?ref=Link

• Frequently Asked Questions (FAQ)
  Answers to common questions about training, certification, and operational requirements.
  >>> View and download FAQ

• Suboxone Administration - Paramedic Poster
  Quick reference for paramedics on patching, documentation, and patient safety.
  >>>View and download poster

• OMC Video
  “Suboxone: Clinical Overview and Patch Guidance”
• RPPEO Training Module
  RPPEO Substance Use Health - Suboxone Training Module (first delivered during Fall 2024 CME): See MedicLEARN

Consultation and Support

• Patching to OMC remains mandatory before administration. This ensures real-time clinical oversight and patient safety.
  >>>Read Medical Advisory on BHP Consultation for Consideration of Suboxone
• For questions or clarification, use MedicASK to connect with RPPEO educators and medical direction.

Your Feedback Matters

We encourage paramedics and services to share feedback on these resources and the implementation process. Your input helps us refine guidance and support tools.