Pilot Study of an Overdose First Aid Program in Juvenile Detention

2020 ◽  
pp. 152483992095002
Author(s):  
Stephanie Chambers ◽  
Melanie Baca ◽  
Ekaterina Navrotskaya ◽  
Annemarie Madaras ◽  
Robert L. Rhyne ◽  
...  
Keyword(s):  
Pilot Study ◽  
First Aid ◽  
Juvenile Detention ◽  
Future Research ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Telephone Interviews ◽  
First Aid Training ◽  
Prevention Interventions

Objectives The purpose of this study was to evaluate the feasibility and short-term impact of a brief opioid overdose prevention and mitigation training administered to detained youth at risk for witnessing an overdose. Methods Adolescents seen in the medical clinic in a youth detention center were screened to determine risk for witnessing an overdose. Eligible adolescents completed a pretraining assessment that included opioid witnessing experiences and knowledge of and attitudes toward opioid overdose prevention. Participants completed a one-on-one overdose first aid training, received a naloxone (Narcan) kit at release, and completed a posttraining assessment of knowledge and attitudes. At 1 month and 3 months postrelease, participants completed telephone interviews to report satisfaction and application of training concepts. Results A total of 39 adolescent residents participated in this pilot study. Rates of recruitment and retention, as well as high rates of witnessing opioid use and overdose, indicate that opioid overdose prevention interventions are warranted with this population. There were significant changes in knowledge, confidence, and readiness to intervene in an opioid overdose from pre- to posttraining. At follow-up, the majority of participants still possessed their naloxone, and all reported sharing information from the training with others and having a plan if they witnessed an overdose. One participant reported completion of an overdose reversal. Implications Opioid overdose prevention training with detained youth is feasible and shows promising impacts on knowledge and application, meriting the need for future research.

scholarly journals A scoping review of factors that influence opioid overdose prevention for justice-involved populations

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Christine E. Grella ◽  
Erika Ostlie ◽  
Christy K. Scott ◽  
Michael L. Dennis ◽  
John Carnevale ◽  
...  
Keyword(s):  
Criminal Justice ◽  
Drug Use ◽  
Perceived Risk ◽  
Opioid Overdose ◽  
Overdose Prevention ◽  
Risk Of Death ◽  
Prevention Interventions ◽  
Implementation And Dissemination ◽  
Injection Use ◽  
Release From Prison

Abstract Background There is a high risk of death from opioid overdose following release from prison. Efforts to develop and implement overdose prevention programs for justice-involved populations have increased in recent years. An understanding of the gaps in knowledge on prevention interventions is needed to accelerate development, implementation, and dissemination of effective strategies. Methods A systematic search process identified 43 published papers addressing opioid overdose prevention in criminal justice settings or among justice-involved populations from 2010 to February 2020. Cross-cutting themes were identified, coded and qualitatively analyzed. Results Papers were coded into five categories: acceptability (n = 8), accessibility (n = 4), effectiveness (n = 5), feasibility (n = 7), and participant overdose risk (n = 19). Common themes were: (1) Acceptability of naloxone is associated with injection drug use, overdose history, and perceived risk within the situational context; (2) Accessibility of naloxone is a function of the interface between corrections and community; (3) Evaluations of overdose prevention interventions are few, but generally show increases in knowledge or reductions in opioid overdose; (4) Coordinated efforts are needed to implement prevention interventions, address logistical challenges, and develop linkages between corrections and community providers; (5) Overdose is highest immediately following release from prison or jail, often preceded by service-system interactions, and associated with drug-use severity, injection use, and mental health disorders, as well as risks in the post-release environment. Conclusion Study findings can inform the development of overdose prevention interventions that target justice-involved individuals and policies to support their implementation across criminal justice and community-based service systems.

Preparing pharmacists to increase naloxone dispensing within community pharmacies under the Pennsylvania standing order

2020 ◽  
Author(s):  
Heather M Santa ◽  
Samira G Amirova ◽  
Daniel J Ventricelli ◽  
George E Downs ◽  
Alexandra A Nowalk ◽  
...  
Keyword(s):  
Community Pharmacists ◽  
The United States ◽  
Health Concern ◽  
Community Pharmacies ◽  
Opioid Overdose ◽  
Patient Counseling ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Standing Order ◽  
Overdose Deaths

Abstract Purpose Opioid misuse and overdose deaths remain a public health concern in the United States. Pennsylvania has one of the highest rates of opioid overdose deaths in the country, with Philadelphia County’s being 3 times higher than the national average. Despite several multimodal interventions, including use of SBIRT (screening, brief intervention, and referral to treatment) methods and naloxone distribution, the rate of overdose deaths remains high. Methods To gain insights on strategies for improving access to naloxone and naloxone distribution by pharmacists in Philadelphia County, a study was conducted in 11 community pharmacies (chain and independent) in Philadelphia. Twenty-four pharmacists were recruited and completed SBIRT and naloxone trainings. Each pharmacy elected to have at least 1 pharmacy champion who received additional training on and helped develop pharmacy site–specific naloxone dispensing protocols. Results Pre-post survey results showed a reduction in stigmatizing attitudes regarding naloxone dispensing and an increase in pharmacists’ understanding of the standing order and appropriate naloxone use. There was an increase in pharmacists’ self-reported confidence in their ability to appropriately identify, discuss, and dispense naloxone to patients. All pharmacies increased their average monthly dispensing rate following protocol implementation. Conclusion Pharmacists who received both trainings were more likely to change naloxone dispensing practices, leading to an overall increase in naloxone dispensing by community pharmacists. The study addressed overall gaps in pharmacists’ knowledge, reduced stigma, and prepared pharmacists to address opioid use and overdose prevention with their patients. The described pharmacist-led patient counseling and intervention service for overdose prevention may be explored as a model for other community pharmacies to adopt to improve naloxone dispensing and similar interventions to reduce overdose deaths.

Opioid Overdose Education, Prevention, and Management (DRAFT)

2018 ◽  
Author(s):  
Bernd Wollschlaeger
Keyword(s):  
The United States ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Death Rates ◽  
Overdose Prevention ◽  
Overdose Death ◽  
Good Samaritan ◽  
Opioid Deaths ◽  
Good Samaritan Laws

In reviewing the elements of opioid overdose education, prevention, and management, this chapter focuses particularly on practical interventions that are available and deserve advocacy; e.g., provision of naloxone to those with opioid use disorder and to possible first responders. It moves from a discussion of the epidemiology of opioid deaths to the more individual topic of patient risk for overdose. Prophylactic interventions in the form of education of the patient’s family and friends, and agreements for treatment with informed consent are described. There follows a discussion of management of the opioid poisoning itself, including use/distribution of naloxone injection. Two figures are included: drug overdose death rates in the United States (2014); a map describing the current states with naloxone or “good Samaritan” laws impacting opioid overdose management. A text box with resources includes directions for initiation of community overdose prevention and intervention schemes.

Naloxone prescribing by psychiatric clinical pharmacists for patients receiving opioid agonist treatment

2015 ◽  
Vol 5 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Michelle Geier ◽  
James J. Gasper
Keyword(s):  
San Francisco ◽  
Improve Patient Safety ◽  
Integrated Treatment ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Overdose Prevention ◽  
Opioid Agonist Treatment ◽  
Clinical Pharmacists ◽  
Prevention Training

Take-home naloxone is an important intervention for addressing opioid overdoses. Patients with a history of a substance use disorder are at an elevated risk of experiencing an overdose, and even in substance-abuse treatment, they may continue to witness peer overdoses. The purpose of this innovative practice was for psychiatric clinical pharmacists to improve access to intranasal naloxone and provide opioid overdose prevention training for patients receiving opioid agonist treatment (OAT). This program took place at a San Francisco Department of Public Health pharmacy that provides OAT (buprenorphine and methadone) to approximately 200 patients with opioid use disorders as part of an integrated treatment program. During the 17-month study period, 47 intranasal naloxone kits were prescribed. Patients reported 3 successful opioid overdose reversals using intranasal naloxone. Based on these findings, psychiatric clinical pharmacists can improve patient safety by increasing access to intranasal naloxone and opioid overdose prevention training for patients receiving OAT.

scholarly journals Preventing opioid overdose with peer-administered naloxone: findings from a rural state

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Bridget L. Hanson ◽  
Rebecca R. Porter ◽  
Amanda L. Zöld ◽  
Heather Terhorst-Miller
Keyword(s):  
Drug Use ◽  
Opioid Use Disorder ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Policy Improvement ◽  
Heroin Users ◽  
Overdose Prevention ◽  
Overdose Death ◽  
High Satisfaction ◽  
Rural State

Abstract Background In response to the opioid epidemic, naloxone distribution programs aim to prevent overdose death by making naloxone available and training people to use it. Peers of individuals at risk of opioid overdose are well-positioned to administer naloxone and prevent overdose death. Methods We conducted key informant interviews with 18 individuals with past or current opioid and heroin drug use who had administered naloxone to a peer during an overdose emergency. Interviews explored individuals’ experiences with administration and their recommendations for program and policy improvement. Data were systematically coded and analyzed for themes. Results Participants sought naloxone rescue kits because they perceived high risk of overdose. They described high satisfaction with training and felt prepared to administer naloxone during overdose incidents. Overwhelmingly, participants perceived naloxone to be effective and emphasized the need to make it widely available. Findings suggest that engagement in overdose prevention strategies other than naloxone differs by gender, with females more likely than males to use multiple different strategies. Participants described that overdose experiences do not have a lasting impact on drug use behaviors. Conclusions Findings support the feasibility of naloxone distribution to peer opioid and heroin users and provide recommendations for policy improvement, including effective and well-advertised Good Samaritan laws and links to treatment for opioid use disorder.

scholarly journals Stakeholders’ Perceptions of Factors Influencing the Use of Take-Home-Naloxone

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 232
Author(s):  
Taylor J. Holland ◽  
Jonathan Penm ◽  
Jacinta Johnson ◽  
Maria Sarantou ◽  
Betty B. Chaar
Keyword(s):  
Scoping Review ◽  
Healthcare Professionals ◽  
Target Population ◽  
Future Research ◽  
Opioid Overdose ◽  
Positive Outcomes ◽  
Community Practice ◽  
Opioid Use ◽  
Home Setting ◽  
Factors Influencing

Background and Aims: Opioid associated death and overdose is a growing burden in societies all over the world. In recent years, legislative changes have increased access to naloxone in the take-home setting for use by patients with a substance use disorder and bystanders, to prevent opioid overdose deaths. However, few studies have explored the factors influencing the uptake by its multiple stakeholders. The aim of this scoping review was to explore the factors influencing the use of take-home naloxone from the perspectives of different stakeholders. Methods: A scoping review methodology was adopted with a systematic search of databases EMBASE, MEDLINE and PubMed. A variation of the search words “naloxone”, “opioid” and “overdose” were used in each database. The articles were screened according to the predetermined inclusion/exclusion criteria and categorized based on their key perspective or target population. Results: The initial database search yielded a total of 1483 articles. After a series of screening processes, 51 articles were included for analysis. Two key stakeholder perspectives emerged: patients and bystanders (n = 36), and healthcare professionals (n = 15). Within the patient and bystander group, a strong consensus arose that there were positive outcomes from increased access to take-home naloxone and relevant training programs. Despite these positive outcomes, some healthcare professionals were concerned that take-home naloxone would encourage high-risk opioid use. Conclusion: Take-home naloxone is slowly being introduced into community practice, with a sense of enthusiasm from patients and bystanders. There are still a number of barriers that need to be addressed from healthcare professionals’ perspective. Future research should be aimed at emergency care professionals outside of the US, who are most experienced with naloxone and its potential impact on the community.

scholarly journals Reducing the stigma surrounding opioid use disorder: evaluating an opioid overdose prevention training program applied to a diverse population

2022 ◽  
Vol 19 (1) ◽  
Author(s):  
Nicholas Alexander Bascou ◽  
Benjamin Haslund-Gourley ◽  
Katrina Amber-Monta ◽  
Kyle Samson ◽  
Nathaniel Goss ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Opioid Use Disorder ◽  
Health Concern ◽  
Opioid Overdose ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Faculty Advisors ◽  
The Usa ◽  
Attitudes And Knowledge ◽  
Overdose Deaths

Abstract Background The opioid epidemic is a rapidly growing public health concern in the USA, as the number of overdose deaths continues to increase each year. One strategy for combating the rising number of overdoses is through opioid overdose prevention programs (OOPPs). Objective To evaluate the effectiveness of an innovative OOPP, with changes in knowledge and attitudes serving as the primary outcome measures. Methods The OOPP was developed by a group of medical students under guidance from faculty advisors. Training sessions focused on understanding stigmatizing factors of opioid use disorder (OUD), as well as protocols for opioid overdose reversal through naloxone administration. Pre- and post-surveys were partially adapted from the opioid overdose attitudes and knowledge scales and administered to all participants. Paired t-tests were conducted to assess differences between pre- and post-surveys. Results A total of 440 individuals participated in the training; 381 completed all or the majority of the survey. Participants came from a diverse set of backgrounds, ages, and experiences. All three knowledge questions showed significant improvements. For attitude questions, significant improvements were found in all three questions evaluating confidence, two of three questions assessing attitudes towards overdose reversal, and four of five questions evaluating stigma and attitudes towards individuals with OUD. Conclusions Our innovative OOPP was effective not only in increasing knowledge but also in improving attitudes towards overdose reversal and reducing stigma towards individuals with OUD. Given the strong improvements in attitudes towards those with OUD, efforts should be made to incorporate the unique focus on biopsychosocial and sociohistorical components into future OOPPs.

scholarly journals Invited Commentary: The Association Between Florida’s Opioid Crackdown and Opioid-Related Mortality—The Roles of Economic Factors and Mortality Misclassification

2020 ◽  
Vol 189 (9) ◽  
pp. 894-897 ◽  
Author(s):  
Sotiris Vandoros
Keyword(s):  
Motor Vehicle ◽  
The United States ◽  
Motor Vehicle Crash ◽  
Future Research ◽  
Opioid Overdose ◽  
Policy Reforms ◽  
Opioid Use ◽  
Car Crashes ◽  
Overdose Mortality ◽  
Related Mortality

Abstract Opioid overdose mortality has been increasing in the United States, and other types of mortality, such as motor vehicle crash deaths, may also be linked to opioid use. In this issue of the Journal, Feder et al. (Am J Epidemiol. 2020;189(9):885–893) examine the association between Florida’s opioid crackdown laws, implemented in 2010–2011, and opioid-related mortality. They found a decrease in numbers of opioid-overdose and car-crash deaths compared with what would have been expected in the absence of such policies. They also found no evidence of any unintended increase in suicides due to poor pain management. The results were robust to alternative methodological approaches. Florida’s opioid policy reforms coincided with the state’s convergence towards national unemployment rates, as well as a new state law prohibiting texting while driving. Because opioid overdose mortality is often associated with economic conditions and because car crashes and suicides may also be linked to the macroeconomic environment, future research should take such factors into account when studying the outcomes of opioid prescribing laws. Another data-related aspect to consider is the misclassification of suicides as car crashes or opioid overdoses. Overall, the findings by Feder et al. are encouraging and can inform policy in other countries facing increasing numbers of opioid overdose deaths.

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