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Pioneering paramedicine: How SCCAD tackles substance use disorders

Chief David Lewis and Kyle Gaines join the podcast to discuss a successful MIH initiative getting patients to treatment counselors

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit

In this episode of Inside EMS, hosts Chris Cebollero and Kelly Grayson discuss innovative approaches in EMS with guests Chief David Lewis and Kyle Gaines from the St. Charles County Ambulance District in Missouri. The district’s unique approach to paramedicine, specifically in terms of substance use disorders, opioid use disorders and behavioral health, forms the crux of the conversation.

Lewis shares how the escalating number of overdose cases necessitated a novel approach to community paramedicine. Starting as a passion project to save lives, the St. Charles County Mobile Integrated Healthcare Network was born from a need to tackle the overdose epidemic more effectively.

Initially adopting a model from Ohio that involved paramedics, social workers and law enforcement officers responding to overdoses, they soon realized patients were reticent to engage when law enforcement was present. This led to the evolution of the program, with paramedics being specially trained to handle sensitive conversations, helping patients access treatment.

Gaines discusses how educating their team members about addiction was instrumental in overcoming initial resistance to the program and ensuring its success. In the years since its inception, the program has grown and has proven to be effective, with about one in four patients they encounter eventually sitting in front of a treatment counselor.

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The Inside EMS podcast is a regular expert discussion of hot topics, clinical issues, operational and leadership lessons for EMTs, paramedics and chiefs
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