Naloxone reverses opioid overdoses, but the care someone receives after that moment matters just as much. In King County, Connections Health Solutions and Emergency Medical Services (EMS) partnered to create a new approach, one that focuses on safety, dignity, and connection rather than automatically sending people to emergency departments. 

Recently, at the American Associate of Emergency Psychiatry National Update on Behavioral Emergencies Conference, Kyle Jasper, MD, medical director at Connections Kirkland Crisis Care Center in Washington, shared this work as an example of how communities can rethink post-overdose care in ways that better serve individuals and the systems designed to support them.

The challenge: What happens after naloxone? 

Dr. Jasper highlighted a critical gap in care: naloxone saves lives, but it doesn't solve everything. After an overdose is reversed, people are often frightened, disoriented, or experiencing withdrawal. Many are taken to emergency departments where they may wait for hours, feel judged, or leave before receiving meaningful help. Others decline transport altogether, missing the chance to connect with substance use or mental health care. 

King County EMS recognized this gap firsthand. Their teams repeatedly encountered people who were medically stable after receiving treatment with naloxone but needed a supportive place to be monitored and offered help, without the barriers that often come with an emergency department visit. 

Building a new pathway together 

The idea of bringing post-naloxone individuals to a crisis care center rather than an emergency department raised understandable concerns, as crisis care centers aren't hospitals, and safety had to come first. Rather than dismiss the possibility, King County EMS and Connections chose to work together. The medical leadership at Connections worked with emergency physicians, addiction medicine specialists, and public health leaders to review the evidence and design a clear, safety-focused protocol that matched what a crisis care center can do well. 

The protocol outlines clear safety guidelines: how long individuals are observed, when they need reassessment, and when emergency department transfer is necessary. Just as important, it creates space for calm, respectful engagement. Individuals are monitored while being offered support, naloxone kits, and connections to treatment, all in a setting designed to reduce stigma. 

What we’ve seen so far 

Dr. Jasper shared encouraging results from implementing this approach. The vast majority of individuals monitored under the protocol were safely discharged back into the community with naloxone and follow-up resources. Many accepted referrals for substance use treatment or medication-assisted treatment. Only a small number require transfer to an emergency department, guided by clear medical criteria. 

For EMS, this created a dependable alternative to the emergency department, one that helps reduce crowding while keeping individuals safe. For individuals getting care, it turned a moment of crisis into an opportunity for connection rather than another difficult experience in a busy emergency room. 

Why this matters 

As Dr. Jasper emphasized in his presentation, overdose reversal is a critical moment, not just medically, but emotionally. It's often when people are most open to help. By working together, King County EMS and Connections showed that it's possible to meet people where they are, prioritize safety, and offer a more humane path forward. 

As more crisis care centers open across King County and Washington State, this model offers a promising way to ensure that saving a life is just the beginning, not the end of care.