scholarly journals Community Case Study of Naloxone Distribution by Hospital-Based Harm Reduction Program for People Who Use Drugs in New York City

2021 ◽  
Vol 6 ◽  
Author(s):  
Farah Riazi ◽  
Wilma Toribio ◽  
Emaun Irani ◽  
Terence M. Hughes ◽  
Zina Huxley-Reicher ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
New York ◽  
New York City ◽  
York City ◽  
Mount Sinai Hospital ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Train The Trainer ◽  
Mount Sinai

Background: In 2017, The Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program at Mount Sinai Hospital became a registered Opioid Overdose Prevention Program (OOPP) and received funding from the New York City Department of Health and Mental Hygiene to develop a program to provide overdose education and naloxone distribution (OEND) training to at risk population and bystanders. We report on the programmatic quality improvement initiatives conducted.Methods: From April 2017 to December 2020, the REACH OOPP conducted 290 opioid overdose reversal trainings, throughout the Mount Sinai Health System and in multiple other community settings. OEND training was at times offered alone and in other settings alongside Hepatitis C Virus point of care testing. Additionally, a “train the trainer” model was implemented whereby medical students and nurses at outpatient clinics were trained to train others.Results: There were 4235 naloxone kits distributed to 3,906 participants. The training venues included hospital settings (patients and medical staff), public events, substance use programs, educational facilities, homeless prevention programs, faith-based organizations, alternative to incarceration programs, and community-based organizations. We implemented two types of training. During outreach sessions, we utilized one-on-one personalized sessions to train bystanders. When training clinic staff in the “train the trainer” model we utilized a standardized didactic presentation with slides. The two top reasons participants reported for being trained were “Just in case I see someone overdose” (59.3%) and “I'm worried that someone I know will overdose OR that I will overdose” (20.2%).Conclusion: The REACH program at Mount Sinai Hospital developed an effective model to train community bystanders and health care staff by leveraging administrative support and building on broader programmatic initiatives to promote drug user health and stigma-free care for people who use drugs. Hospitals do not currently mandate staff training or keeping naloxone stocked at inpatient units or outpatients clinics posing a challenge when implementing an OEND program in this setting. A recommended policy change needed to decrease overdose deaths is for hospitals to be required to implement systematic naloxone education and access for all health care personal and at risk patients.

scholarly journals Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study

10.2196/22411 ◽  
2020 ◽  
Vol 4 (12) ◽  
pp. e22411
Author(s):  
Alex S Bennett ◽  
Robert Freeman ◽  
Don C Des Jarlais ◽  
Ian David Aronson
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
York City ◽  
Shared Responsibility ◽  
Opioid Antagonist ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Negative Consequences ◽  
Qualitative Interview Study

Background Many people use opioids and are at risk of overdose. Naloxone is an opioid antagonist used to counter the effects of opioid overdose. There is an increased availability of naloxone in New York City; however, many who use opioids decline no-cost naloxone even when offered. Others may have the medication but opt not to carry it and report that they would be reluctant to administer it if they were to witness an overdose. Objective We aim to better understand why people who use opioids may be reluctant to accept, carry, and administer naloxone, and to inform the development of messaging content that addresses barriers to its acceptance and use. Methods We conducted formative qualitative interviews with 20 people who use opioids who are 18 years and older in New York City. Participants were recruited via key informants and chain referral. Results Participants cited 4 main barriers that may impede rates of naloxone acceptance, possession, and use: (1) stigma related to substance use, (2) indifference toward overdose, (3) fear of negative consequences of carrying naloxone, and (4) fear of misrecognizing the need for naloxone. Participants also offered suggestions about messaging content to tackle the identified barriers, including messages designed to normalize naloxone possession and use, encourage shared responsibility for community health, and elicit empathy for people who use drugs. Taken together, participants’ narratives hold implications for the following potential messaging content: (1) naloxone is short-acting, and withdrawal sickness does not have to be long-lasting; (2) it is critical to accurately identify an opioid-involved overdose; (3) anyone can overdose; (4) naloxone cannot do harm; and (5) the prompt administration of the medication can help ensure that someone can enjoy another day. Finally, participants suggested that messaging should also debunk myths and stereotypes about people who use drugs more generally; people who use opioids who reverse overdoses should be framed as lay public health advocates and not just “others” to be managed with stigmatizing practices and language. Conclusions It must be made a public health priority to get naloxone to people who use opioids who are best positioned to reverse an overdose, and to increase the likelihood that they will carry naloxone and use it when needed. Developing, tailoring, and deploying messages to address stigma, indifference toward overdose, fear and trepidation about reversing an overdose, and fear of police involvement may help alleviate fears among some people who are reluctant to obtain naloxone and use the medication on someone in an overdose situation.

Manual of Nursing Procedures, The Mount Sinai Hospital, New York City

1947 ◽  
Vol 47 (6) ◽  
pp. 433
Author(s):  
Margaret F. Heyse ◽  
Grace A. Warman
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Mount Sinai Hospital ◽  
Mount Sinai

scholarly journals Reasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview Study (Preprint)

2020 ◽  
Author(s):  
Alex S Bennett ◽  
Robert Freeman ◽  
Don C Des Jarlais ◽  
Ian David Aronson
Keyword(s):  
Public Health ◽  
New York ◽  
New York City ◽  
York City ◽  
Shared Responsibility ◽  
Opioid Antagonist ◽  
People Who Use Drugs ◽  
Opioid Overdose ◽  
Negative Consequences ◽  
Qualitative Interview Study

BACKGROUND Many people use opioids and are at risk of overdose. Naloxone is an opioid antagonist used to counter the effects of opioid overdose. There is an increased availability of naloxone in New York City; however, many who use opioids decline no-cost naloxone even when offered. Others may have the medication but opt not to carry it and report that they would be reluctant to administer it if they were to witness an overdose. OBJECTIVE We aim to better understand why people who use opioids may be reluctant to accept, carry, and administer naloxone, and to inform the development of messaging content that addresses barriers to its acceptance and use. METHODS We conducted formative qualitative interviews with 20 people who use opioids who are 18 years and older in New York City. Participants were recruited via key informants and chain referral. RESULTS Participants cited 4 main barriers that may impede rates of naloxone acceptance, possession, and use: (1) stigma related to substance use, (2) indifference toward overdose, (3) fear of negative consequences of carrying naloxone, and (4) fear of misrecognizing the need for naloxone. Participants also offered suggestions about messaging content to tackle the identified barriers, including messages designed to normalize naloxone possession and use, encourage shared responsibility for community health, and elicit empathy for people who use drugs. Taken together, participants’ narratives hold implications for the following potential messaging content: (1) naloxone is short-acting, and withdrawal sickness does not have to be long-lasting; (2) it is critical to accurately identify an opioid-involved overdose; (3) anyone can overdose; (4) naloxone cannot do harm; and (5) the prompt administration of the medication can help ensure that someone can enjoy another day. Finally, participants suggested that messaging should also debunk myths and stereotypes about people who use drugs more generally; people who use opioids who reverse overdoses should be framed as lay public health advocates and not just “others” to be managed with stigmatizing practices and language. CONCLUSIONS It must be made a public health priority to get naloxone to people who use opioids who are best positioned to reverse an overdose, and to increase the likelihood that they will carry naloxone and use it when needed. Developing, tailoring, and deploying messages to address stigma, indifference toward overdose, fear and trepidation about reversing an overdose, and fear of police involvement may help alleviate fears among some people who are reluctant to obtain naloxone and use the medication on someone in an overdose situation.

scholarly journals Neonatal outcomes during the COVID-19 pandemic in New York City

2020 ◽  
Author(s):  
Felix Richter ◽  
Arielle S. Strasser ◽  
Mayte Suarez-Farinas ◽  
Shan Zhao ◽  
Girish N. Nadkarni ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Neonatal Intensive Care ◽  
Time Window ◽  
Time Windows ◽  
The United States ◽  
Mount Sinai Hospital ◽  
Premature Births ◽  
Mount Sinai

ABSTRACTWe explored rates of premature births and neonatal intensive care unit (NICU) admissions at the Mount Sinai Hospital after the implementation of COVID-19 lockdown measures (March 16, 2020) and phase one reopening (June 8, 2020), comparing them to those of the same time periods from 2012-2019. Mount Sinai Hospital is in New York City (NYC), an early epicenter of COVID-19 in the United States, which was heavily impacted by the pandemic during the study period. Among 43,963 singleton births, we observed no difference in either outcome after the implementation of lockdown measures when compared to the same trends in prior years (p=0.09-0.35). Of interest, we observed a statistically significant decrease in premature births after NYC phase one reopening compared to those of the same time period in 2012-2019 across all time windows (p=0.0028-0.049), and a statistically significant decrease in NICU admissions over the largest time window (2.75 months) compared to prior years (p=0.0011).

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