{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:40:03Z","timestamp":1787593203943,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T00:00:00Z","timestamp":1676073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T00:00:00Z","timestamp":1676073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004476","name":"Chinese Center for Disease Control and Prevention","doi-asserted-by":"publisher","award":["NB01OT009316\u201001\u201000"],"award-info":[{"award-number":["NB01OT009316\u201001\u201000"]}],"id":[{"id":"10.13039\/501100004476","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008760","name":"National Highway Traffic Safety Administration","doi-asserted-by":"publisher","award":["405\u2010c#20.616"],"award-info":[{"award-number":["405\u2010c#20.616"]}],"id":[{"id":"10.13039\/100008760","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To create a novel emergency medical service (EMS) opioid\u2010related incident (ORI) tiering framework to describe more accurately the opioid epidemic in Massachusetts. By classifying the data, we could more accurately detail differing trends among the new categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Free\u2010text fields of Massachusetts EMS reports, from 2013 through 2020, were analyzed to identify ORIs and then categorized into a five\u2010tier severity cascade based on symptom presentation: \u2018dead on arrival,\u2019 \u2018acute overdose,\u2019 \u2018intoxication,\u2019 \u2018withdrawal\u2019 and \u2018other ORI.\u2019 As a validation of the new classification, an emergency medical technician, paramedic and emergency medical physician reviewed clinical reports and assigned a severity category to 100 randomly selected cases. The algorithm then assessed the same 100 cases to determine if it could accurately identify the severity category for each case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Validation of the algorithm by clinical review indicated a substantial level of agreement between the algorithm and the reviewers. Over half of all ORIs were acute overdose (55%), 21% were intoxication, 20% were other ORI, 3% were withdrawal, and 1% were dead on arrival. Overall ORIs decreased in 2020, but the number of \u2018dead on arrival\u2019 increased 32% from 2019. Administration of naloxone also differed between the categories, with 95% of acute overdose and 29% of intoxication receiving naloxone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This novel categorization of emergency medical service opioid\u2010related incidents in Massachusetts, United States, reveals new trend details and strains on the emergency medical service system. Using these categories also improves dataset linkage within the state and interstate rate comparisons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.16148","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T01:10:48Z","timestamp":1675041048000},"page":"1381-1386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Redefining and categorizing emergency medical service opioid\u2010related incidents in Massachusetts"],"prefix":"10.1111","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2965-6113","authenticated-orcid":false,"given":"Katarina","family":"Jones","sequence":"first","affiliation":[{"name":"Massachusetts Department of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Bernson","sequence":"additional","affiliation":[{"name":"Massachusetts Department of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine T.","family":"Fillo","sequence":"additional","affiliation":[{"name":"Massachusetts Department of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Bettano","sequence":"additional","affiliation":[{"name":"Massachusetts Department of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,11]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Mass. Gen. Laws Chapter 55. (2015).An act requiring certain reports for opiate overdoses."},{"key":"e_1_2_9_3_1","unstructured":"Mass. Regs. AR 5\u2010403. (2019).Administrative requirement manual: Statewide EMS minimum data set."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6731a2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/10903127.2013.792888"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/10903127.2017.1387628"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.5210\/ojphi.v11i1.9746"},{"issue":"2","key":"e_1_2_9_8_1","first-page":"41","article-title":"Identification and description of non\u2010fatal opioid overdoses using Rhode Island EMS data, 2016\u20132018","volume":"102","author":"Lasher L","year":"2019","journal-title":"R I Med J"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.4137\/SART.S7090"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-019-1048-y"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajad.12862"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1348\/000711006X126600"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108176"},{"key":"e_1_2_9_15_1","unstructured":"Massachusetts Office of Emergency Medical Services.Administrative requirement manual: Minimum standards for first responder training in first aid epinephrine auto\u2010injector and naloxone use(2016). Massachusetts Department of Public Health."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2021.1949661"},{"key":"e_1_2_9_17_1","unstructured":"Rhode Island Department of Public Health.Rhode Island enhanced state opioid overdose surveillance: Case definition for emergency medical services. Updated March2019."}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16148","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/add.16148","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T17:17:33Z","timestamp":1787591853000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.16148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,11]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1111\/add.16148"],"URL":"https:\/\/doi.org\/10.1111\/add.16148","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,11]]},"assertion":[{"value":"2022-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}