Neighborhood-Level & Spatial Characteristics Associated with Lay Naloxone Reversal Events & Opioid Overdose Deaths

There were over 23,000 opioid overdose deaths in the USA in 2013, and opioid-related mortality is increasing. Increased access to naloxone, particularly through community-based lay naloxone distribution, is a widely supported strategy to reduce opioid overdose mortality; however, little is known about the ecological and spatial patterns of the distribution and utilization of lay naloxone. 

This study aims to investigate the neighborhood-level correlates and spatial relationships of lay naloxone distribution and utilization and opioid overdose deaths. We determined the locations of lay naloxone distribution sites and the number of unintentional opioid overdose deaths and reported reversal events in San Francisco census tracts (n = 195) from 2010 to 2012. 

We used Wilcoxon rank-sum tests to compare census tract characteristics across tracts adjacent and not adjacent to distribution sites and multivariable negative binomial regression models to assess the association between census tract characteristics, including distance to the nearest site, and counts of opioid overdose deaths and naloxone reversal events. 

Three hundred forty-two opioid overdose deaths and 316 overdose reversals with valid location data were included in our analysis. Census tracts including or adjacent to a distribution site had higher income inequality, lower percentage black or African American residents, more drug arrests, higher population density, more overdose deaths, and more reversal events (all p < 0.05). 

In multivariable analysis, greater distance to the nearest distribution site (up to a distance of 4000 m) was associated with a lower count of Naloxone reversals [incidence rate ratio (IRR) = 0.51 per 500 m increase, 95% CI 0.39-0.67, p < 0.001] but was not significantly associated with opioid overdose deaths. 

These findings affirm that locating lay naloxone distribution sites in areas with high levels of substance use and overdose risk facilitates reversals of opioid overdoses in those immediate areas but suggests that alternative delivery methods may be necessary to reach individuals in other areas with less concentrated risk.

Purchase full article at:   http://goo.gl/V40N93

By:  Rowe C1, Santos GM2,3, Vittinghoff E3, Wheeler E4, Davidson P5, Coffin PO2,3.

• 1San Francisco Department of Public Health, 25 Van Ness Avenue, Ste. 500, San Francisco, CA, 94102, USA. chris.rowe@sfdph.org.
• 2San Francisco Department of Public Health, 25 Van Ness Avenue, Ste. 500, San Francisco, CA, 94102, USA.
• 3University of California, San Francisco, 500 Parnassus Avenue, San Francisco, CA, 94143, USA.
• 4Drug Overdose Prevention and Education Project, Harm Reduction Coalition, 1440 Broadway, Suite 902, Oakland, CA, 94612, USA.
• 5University of California, San Diego, 9500 Gilman Drive, La Jolla, California, CA, 92093, USA. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Engagement in a National Naloxone Program among People Who Inject Drugs

HIGHLINGHTS

• Access to naloxone among PWID increased significantly from 8% in 2011–2012 to 32% in 2013–2014.
• Carriage of naloxone decreased significantly from 16% in 2011–2012 to 5% in 2013–2014.
• Community services and prisons were equally efficient at targeting their naloxone supplies.

BACKGROUND:

Availability of the opioid antagonist naloxone for lay administration has grown substantially since first proposed in 1996. Gaps remain, though, in our understanding of how people who inject drugs (PWID) engage with naloxone programmes over time.

AIMS:

This paper aimed to address three specific evidence gaps: the extent of naloxone supply to PWID; supply-source (community or prisons); and the carriage of naloxone among PWID.

MATERIALS AND METHODS:

Analysis of Scotland's Needle Exchange Surveillance Initiative (NESI) responses in 2011-2012 and 2013-2014 was undertaken with a specific focus on the extent of Scotland's naloxone supply to PWID; including by source (community or prisons); and on the carriage of naloxone. Differences in responses between the two surveys were measured using Chi-square tests together with 95% confidence intervals for rate-differences over time.

RESULTS:

The proportion of NESI participants who reported that they had been prescribed naloxone within the last year increased significantly from 8% (175/2146; 95% CI: 7-9%) in 2011-2012 to 32% (745/2331; 95% CI: 30% to 34%) in 2013-2014. In contrast, the proportion of NESI participants who carried naloxone with them on the day they were interviewed decreased significantly from 16% (27/169; 95% CI: 10% to 22%) in 2011-2012 to 5% (39/741; 95% CI: 4% to 7%) in 2013-2014.

CONCLUSIONS:

The supply of naloxone to PWID has increased significantly since the introduction of a National Naloxone Programme in Scotland in January 2011. In contrast, naloxone carriage is low and decreased between the two NESI surveys; this area requires further investigation.

Purchase full article at:   http://goo.gl/H83xFl

By:  McAuley A1, Munro A2, Bird SM3, Hutchinson SJ4, Goldberg DJ4, Taylor A2.

• 1Health Protection Scotland, Meridian Court, Cadogan Street, Glasgow G2 6QE, UK; Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK. Electronic address: andrew.mcauley@nhs.net.
• 2School of Media, Culture and Society, University of the West of Scotland, Paisley PA1 2BE, UK.
• 3MRC Biostatistics Unit, Cambridge CB2 0SR, UK; Department of Mathematics and Statistics, Strathclyde University, Glasgow G1 1XH, UK.
• 4Health Protection Scotland, Meridian Court, Cadogan Street, Glasgow G2 6QE, UK; Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK. 
• Drug Alcohol Depend. 2016 Mar 3. pii: S0376-8716(16)00106-X. doi: 10.1016/j.drugalcdep.2016.02.031. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Correlates of Nine-Month Retention following Interim Buprenorphine-Naloxone Treatment in Opioid Dependence: A Pilot Study

Interim medication-only treatment has been suggested for the initiation of opioid maintenance treatment (OMT) in opioid-dependent subjects, but this rarely has been studied using buprenorphine instead of methadone. Following a pilot trial assessing interim buprenorphine-naloxone treatment in order to facilitate transfer into OMT, we here aimed to study retention, and potential correlates of retention, in full-scale treatment. Thirty-six patients successfully referred from a waiting list through an interim treatment phase were followed for nine months in OMT. Baseline characteristics, as well as urine analyses during the interim phase and during full-scale OMT, were studied as potential correlates of retention. The nine-month retention in OMT was 83 percent (n = 30). While interim-phase urine samples positive for benzodiazepines did not significantly predict dropout from full-scale OMT (p = 0.09), urine samples positive for benzodiazepines within full-scale OMT were significantly associated with dropout (p < 0.01), in contrast to other substances and baseline characteristics. Retention remained high through nine months in this pilot study sample of patients referred through buprenorphine-naloxone interim treatment, but use of benzodiazepines is problematic, and the present data suggest that it may be associated with treatment dropout.

…The use of benzodiazepines during interim treatment and during full-scale OMT was the only variable associated with dropout in the present study. Although the number of dropouts in this pilot study was low, urines positive for benzodiazepines in the interim condition tended to be associated with a negative outcome once referred to the full-scale program but did not reach statistical significance (p = 0.09). However, significantly, a negative outcome in full-scale OMT was associated with the use of benzodiazepines within that OMT treatment setting, which was not the case for any other substance, suggesting that benzodiazepines may play a major role in the clinical picture of patients with a negative treatment course in opioid dependence.

The seemingly negative association between retention and benzodiazepine use during treatment of opioid dependence may require further attention in research and in clinical practice. In the present study, at baseline, the frequency of use of benzodiazepines was comparable to that of the main drug of these primarily opioid-dependent subjects. In contrast to the high rates of continued benzodiazepine use, urine samples positive for opiates were very infrequent in the full-scale OMT phase, markedly lower than in many other studies [35,36], and opioid-positive urines were not associated with dropout in OMT. The role of benzodiazepines in the present results, compared to the role of opioids, strengthens the impression that polydrug use, particularly including the use of benzodiazepines, may present a potentially even larger challenge in the treatment of severe opioid dependence than the actual primary opioid-related disorder.

Patients with a high level of benzodiazepine use could represent a group with more complicated psychiatric problems and more severe substance-related problems [29, 37]. In the present study, patients dropping out of treatment did not report more use of benzodiazepines during the last 30 days prior to study start, but still, this type of substance use was associated with a negative outcome once in full-scale treatment. It cannot be excluded that intake of benzodiazepines actually increases when the intake of illicit opioids decreases in treatment, at least in a subset of individuals…

Full article at:   http://goo.gl/7QXGbu

By:  A. Håkansson, 1 , 2 , * C. Widinghoff, 1 , 2 T. Abrahamsson, 1 , 2 and C. Gedeon 1 , 3

¹Department of Clinical Sciences Lund, Division of Psychiatry, Lund University, 221 85 Lund, Sweden

²Malmö Addiction Center, Department of Psychiatry, 205 02 Malmö, Skane Region, Sweden

³Solstenen Outpatient Unit for Opiate Maintenance Treatment, Östra Mårtensgatan 15, 223 61 Lund, Sweden

*A. Håkansson: Email: es.ul.dem@nossnakah.c_sredna

Academic Editor: Dennis M. Donovan

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

‘What Is Known About Community Pharmacy Supply of Naloxone’: A Scoping Review

Highlights

• Take-home naloxone may be expanded through community pharmacy.
• Early work indicates pharmacists are willing to supply naloxone.
• Existing models for community pharmacy of naloxone supply exist.
• Supply models have important cost implications for consumers.
• Larger implementation studies are needed to determine effectiveness.

Abstract

Background

There is growing evidence that expanded supply of take-home naloxone to prevent opioid overdose deaths is needed. Potential routes for expansion of naloxone provision include through community pharmacies. The aim of this scoping review is to establish what is known about community pharmacy supply of naloxone, in light of unique challenges and opportunities present in pharmacy settings.

Methods

A scoping review methodology was employed using the six stage iterative process advocated by Arksey and O’ Malley (2005) and Levac et al. (2010). Searches used key words and terms such as ‘naloxone’; ‘overdose prevention/drug overdose/opiate overdose’; ‘community/retail pharmacy’; ‘pharmacist/pharmacy/community pharmacy/pharmaceutical services’; ‘professional practice/role’; ‘community care’; attitude of health personnel’; ‘training/supply/cost’). Appropriate search terms were selected for each database. After initial exploratory searches, comprehensive searches were conducted with Cochrane Database of Systematic Reviews, Medline, Medline in Process, Embase, PsycINFO and CINAHL. Eligibility criteria centered on whether studies broadly described supply of naloxone in community pharmacy or had content relating to community pharmacy supply.

Results

The search identified 95 articles, of which 16 were related to pharmacy supply of naloxone. Five themes were presented after initial review of the data and consultation with the project Expert Group, and are; ‘Pharmacists Perceptions of Naloxone: Facilitators and Barriers’, ‘Patient Populations: Identification and Recruitment’, ‘Supply Systems and Cost’, ‘Legal Issues’, and ‘Training of Pharmacists and Community Pharmacy Naloxone Recipients’.

Conclusion

The community pharmacy based route for distribution of take home naloxone provision warrants further consideration and development. Existing strengths include a range of established supply models, and training curricula, few direct concerns regarding legal liability of pharmacists in the supply of naloxone (once legal supply systems have been established) and the wide range of potential identifiable patient populations, which include pain patients that may not be in contact with existing naloxone supply programmes.

Purchase full article at:   http://goo.gl/G49VMg

By:  Suzanne Nielsen, Marie Claire Van Hout

Affiliations

• National Drug and Alcohol Research Centre, University of New South Wales, Australia

• Drug and Alcohol Services, South Eastern Sydney Local Health District

Correspondence

• Corresponding author.at: National Drug and Alcohol Research Centre University of New South Wales Sydney 2052, Australia.

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Assessment of Provider Attitudes Toward #Naloxone on Twitter

BACKGROUND:

As opioid overdose rates continue to pose a major public health crisis, the need for naloxone treatment by emergency first responders is critical. Little is known about the views of those who administer naloxone. The current study examines attitudes of health professionals on the social media platform Twitter to better understand their perceptions of opioid users, the role of naloxone and potential training needs.

METHODS:

Public comments on Twitter regarding naloxone were collected for a period of three consecutive months. The occupations of individuals who posted tweets were identified through Twitter profiles or hashtags. Categories of emergency service first responders and medical personnel were created. Qualitative analysis using a grounded theory approach was used to produce thematic content. The relationships between occupation and each theme were analyzed using Pearson chi-square statistics and post-hoc analyses.

RESULTS:

A total of 368 individuals posted 467 naloxone-related tweets. Occupations consisted of professional first responders such as emergency medical technicians (EMTs), firefighters, and paramedics (n = 122); law enforcement officers (n = 70); nurses (n = 62); physicians (n = 48); other health professionals including pharmacists, pharmacy technicians, counselors, social workers (n = 31); naloxone-trained individuals (n = 12); and students (n = 23). Primary themes included burnout, education and training, information-seeking, news updates, optimism, policy and economics, stigma, and treatment. The highest levels of burnout, fatigue and stigma regarding naloxone and opioid overdose were among nurses, EMTs, other health care providers and physicians. In contrast, individuals who self-identified as "naloxone-trained" had the highest optimism and the lowest amount of burnout and stigma.

CONCLUSIONS:

Provider training and refinement of naloxone administration procedures is needed to improve treatment outcomes and reduce provider stigma. Social networking sites such as Twitter may have potential for offering psychoeducation to health care providers.

Purchase full article at:   http://goo.gl/Ha5SlI

By:  Haug NA1, Bielenberg J1, Linder SH2, Lembke A3.

• 1 PGSP-Stanford University Psy.D. Consortium, Palo Alto University , Los Altos , CA , USA.
• 2 VA Palo Alto Health Care System , Palo Alto , CA , USA.
• 3 Department of Psychiatry and Behavioral Sciences , Stanford University School of Medicine , Stanford , CA , USA.
• Subst Abus. 2016 Feb 9:0.  

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Stakeholder Perceptions & Operational Barriers in the Training & Distribution of Take-Home Naloxone within Prisons in England

BACKGROUND:

The aim of the study was to assess potential barriers and challenges to the implementation of take-home naloxone (THN) across ten prisons in one region of England.

METHODS:

Qualitative interviews deploying a grounded theory approach were utilised over a 12- to 18-month period that included an on-going structured dialogue with strategic and operational prison staff from the ten prisons and other key stakeholders (n = 17). Prisoner perceptions were addressed through four purposive focus groups belonging to different establishments (n = 26). Document analysis also included report minutes and access to management information and local performance reports. The data were thematically interpreted using visual mapping techniques.

RESULTS:

The distribution and implementation of THN in a prison setting was characterised by significant barriers and challenges. As a result, four main themes were identified: a wide range of negative and confused perceptions of THN amongst prison staff and prisoners; inherent difficulties with the identification and engagement of eligible prisoners; the need to focus on individual prison processes to enhance the effective distribution of THN; and the need for senior prison staff engagement.

CONCLUSIONS:

The distribution of THN within a custodial setting requires consideration of a number of important factors which are discussed...

Since I’ve come to this jail, everyone [has been] banging on about getting myself sorted and off the drugs and everything you know. It’s taken a while and I’m in the right place to move forward for once, no more gear – nothing. I’m done with that life….. I’m clean now with no intention of using, so why do I need this? [Male prisoner, Prison 5]

What’ll happen is that I will leave here and as soon I get my feet on the ground the police will stop me, as always, and say…..’What’s this? You must be using again - you’re nicked [arrested]'. [Male prisoner, Prison 2]

Many of my staff understand what we are trying to do here which is get prisoners off drugs and abstinent by the time they leave here…if not abstinent entirely then at least in a positon to consider an abstinent life. For many staff, and it’s not just uniformed staff [prison officers], just handing out Naloxone give out the wrong message that says it’s alright now you can keep on using. I don’t agree with this view myself but I know they [staff] think it. [Healthcare Manager, Naloxone Action Group]

I am very concerned that Naloxone could be given out by prison officers or anyone else without healthcare input. The risks will be too great if something went wrong and the wrong person got hold of it. [Healthcare nurse, Naloxone Action Group] 

Full article at:   http://goo.gl/588N9e

By:   Sondhi A1, Ryan G2, Day E3.

• 1Therapeutic Solutions (Addictions) Communications House, 26 York Street, London, W1U 6PZ, UK. arun.sondhi@therapeutic-solutions.org.uk.
• 2Public Health England, 2nd Floor Skipton House London Road Elephant & Castle, London, SE1 6LH, UK.
• 3Addiction Psychiatry, Addictions Department, National Addiction Centre, Addiction Sciences Building, 4 Windsor Walk, Denmark Hill, London, SE5 8AF, UK.
• Harm Reduct J. 2016 Feb 3;13(1):5. doi: 10.1186/s12954-016-0094-1. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Brief Overdose Education Is Sufficient for Naloxone Distribution to Opioid Users

BACKGROUND:

While drug users are frequently equipped with naloxone for lay opioid overdose reversal, the amount of education needed to ensure knowledge of indications and administration is unknown.

METHODS:

We administered four instruments, assessing comfort and knowledge around opioid overdose and naloxone administration, to opioid users receiving naloxone for the first time (N=60) and upon returning for a refill (N=54) at community distribution programs. Participants completed the instruments prior to receiving naloxone; first-time recipients repeated the instruments immediately after the standardized 5-10min education.

RESULTS:

Comfort with recognition of, response to, and administration of naloxone for an overdose event significantly increased after brief education among first-time recipients (p<0.05). Knowledge of appropriate responses to opioid overdose was high across all assessments; 96% of participants could identify at least one acceptable action to assess and one acceptable action to care for an opioid overdose. Facility with naloxone administration was high across all assessments and significantly increased for intranasal administration after education for first-time recipients (p<0.001). First-time recipients (before and after education) and refillers demonstrated a high level of knowledge on the Brief Overdose Recognition and Response Assessment, correctly identifying a mean of 13.7 out of 16 overdose scenarios.

CONCLUSIONS:

Opioid users seeking naloxone in San Francisco have a high level of baseline knowledge around recognizing and responding to opioid overdose and those returning for refills retain that knowledge. Brief education is sufficient to improve comfort and facility in recognizing and managing overdos

Purchase full article at:   http://goo.gl/Cmu7J1

By:  Behar E1, Santos GM2, Wheeler E3, Rowe C4, Coffin PO2.

• 1San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA. Electronic address: Emily.behar@sfdph.org.
• 2San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; University of California San Francisco, San Francisco, CA, USA.
• 3Harm Reduction Coalition, Oakland, CA, USA.
• 4San Francisco Department of Public Health, Substance Use Research Unit, San Francisco, CA, USA; University of California Berkeley, Berkeley, CA, USA.
• Drug Alcohol Depend. 2015 Mar 1;148:209-12. doi: 10.1016/j.drugalcdep.2014.12.009. Epub 2014 Dec 19. 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Evaluation of Overdose Prevention Trainings in NYC: Knowledge and Self-Efficacy among Participants Twelve Months after Training

BACKGROUND:

Prevention of unintentional opioid overdose deaths is effective through overdose prevention trainings (OPTs), in which laypersons are taught overdose response through six actions. This longitudinal study examines trainee knowledge twelve months after OPT completion.

METHODS:

We enrolled participants following OPT at six sites. At twelve months follow-up, participants were asked to: name the drug overdoses that naloxone reverses; name overdose response actions. We created a 6-point scale comprised of number of correct overdose response actions mentioned (check breathing; administer sternum rub; call 911; give rescue breathing; administer naloxone; put victim in recovery position). We compared mean knowledge by participant sociodemographic characteristics, confidence, and site of OPT training (indoors versus outdoors).

RESULTS:

273 of 344 OPT participants were reached at twelve months. Nearly all (99%) participants identified that naloxone reverses heroin; 77% opioid analgesics; and 68% methadone overdoses. Overdose response actions most frequently mentioned were giving naloxone (86%) and calling 911 (76%). The remaining four actions were mentioned by less than 40% of participants. Overall mean knowledge score was 2.7 out of 6. Mean knowledge scores were higher for college graduates than those with less than college education (3.2 vs 2.6, p<0.001), for those who felt very confident (mean score (ms) = 2.9), compared to somewhat confident (ms = 2.4) and a little or not at all confident (ms = 1.5) in their ability to reverse an overdose (p<.001), and for indoor-training recipients (3.0 vs 2.5, p = 0.02). There were no differences in mean knowledge scores for trainees by age, race, or gender.

CONCLUSIONS:

Our findings suggest the need for several improvements in OPT curriculum, including emphasis on naloxone reversal of opioid analgesic and methadone overdoses, and all 6 rescue actions. Lower knowledge scores among outdoor-trained participants likely reflect session brevity, suggesting that outdoor trainings need to be enhanced.

Purchase full article at:   http://goo.gl/TOc94R

By:  Maldjian L1, Siegler A1, Kunins HV1.

• 1a Department of Health and Mental Hygiene , Bureau of Alcohol and Drug Use Prevention, Care and Treatment , Queens , NY , USA.
• Subst Abus. 2016 Jan 5:0

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Focused Use of Drug Screening in Overdose Patients Increases Impact on Management

Abstract

Drug poisoning is a common cause for attendance in the emergency department. Several toxicology centres suggest performing urinary drug screens, even though they rarely influence patient management.

STUDY OBJECTIVES:

Measuring the impact on patient management, in a University Emergency Department with approximately 40,000 admissions annually, of a rapid urinary drug screening test using specifically focused indications. Drug screening was restricted to patients having a first psychotic episode or cases demonstrating respiratory failure, coma, seizures, a sympathomimetic toxidrome, severe opiate overdose necessitating naloxone, hypotension, ventricular arrhythmia, acquired long QT or QRS >100 ms, and high-degree heart block.

METHODS:

Retrospective analysis of Triage® TOX drug screen tests performed between September 2009 and November 2011, and between January 2013 and March 2014.

RESULTS:

A total of 262 patients were included, mean age 35 ± 14.6 (standard deviation) years, 63% men; 29% poisoning with alcohol, and 2.3% deaths. Indications for testing were as follows: 34% were first psychotic episodes; 20% had acute respiratory failure; 16% coma; 8% seizures; 8% sympathomimetic toxidromes; 7% severe opioid toxidromes; 4% hypotension; 3% ventricular arrhythmias or acquired long QT intervals on electrocardiogram. A total of 78% of the tests were positive (median two substances, maximum five). The test resulted in drug-specific therapy in 6.1%, drug specific diagnostic tests in 13.3 %, prolonged monitoring in 10.7% of methadone-positive tests, and psychiatric admission in 4.2%. Overall, 34.3% tests influenced patient management.

CONCLUSIONS:

In contrast to previous studies showing modest effects of toxicological testing, restricted use of rapid urinary drug testing increases the impact on management of suspected overdose patients in the ED.

Below:  Indications for urinary drug screening (n = 369) in 262 patients.

Arrhythmia or long QT = QT prolongation >480 ms, or ventricular tachycardia or flutter, or torsade de pointes tachycardia; Hypotension = systolic hypotension (<80 mm Hg); Opiate toxidrome = if requiring antagonist administration; Psychosis = first psychotic episode; Resp failure = acute respiratory failure (pCO₂ 45‑80 mm Hg or emergency intubation); Sympathomimetic = clinical signs of sympathomimetic toxicity

Below:  Spectrum of substances detected with the Triage^® TOX screen (204 positive urine samples with 348 substances detected). AMP = amphetamines; BAR = barbiturates; BZO = benzodiazepines; COC = cocaine; MAMP = metamphetamines; MTD = methadone; OPI = opiates; PAR = paracetamol; TCA = tricyclic antidepressants; THC = tetrahydrocannabinoids

Below:  Impact of test results on clinical decisions (in %, n = 90) consecutive to the detection of substances with the Triage^®TOX drug screen (n = 262 tests). Toxin-specific administration of naloxone, flumazenil or N-acetycysteine or other drug-specific treatments after test results.

Diagnostic tests = drug-related diagnostic tests ordered after test result; disposition = psychiatry transfer influenced by negative screening / somatic transfer if positive; prolonged monitoring = longer monitoring when methadone positive

Full article at:   http://goo.gl/MGRtlR

By:   Erdmann A1, Werner D2, Hugli O3, Yersin B3.

• 1Emergency Department, University Hospital (CHUV), Lausanne, Switzerland; Angiology Department, University Hospital (CHUV), Lausanne, Switzerland.
• 2Laboratory of clinical chemistry, University Hospital (CHUV), Lausanne, Switzerland.
• 3Emergency Department, University Hospital (CHUV), Lausanne, Switzerland.
• Swiss Med Wkly. 2015 Dec 28;145:w14242. doi: 10.4414/smw.2015.14242. eCollection 2015.
• 
  
• More at:  https://twitter.com/hiv insight
• And: http://twitter.com/Prison Health

An Initial Evaluation of Web-Based Opioid Overdose Education

BACKGROUND:

Fatal opioid overdose is a significant public health concern in the United States. One approach to reducing fatalities is expanding overdose response education to broader audiences. This study examined responses to a web-based overdose education tool.

METHODS:

The results of 422 anonymous surveys submitted on www.stopoverdose.org were analyzed for participant demographics, knowledge of opioid overdose recognition and response, and knowledge of Washington's Good Samaritan overdose law. Characteristics, knowledge, and planned behavior of respondents with professional versus personal interest in overdose education were compared.

RESULTS:

Most respondents were age 35 or older (57%) and female (65%). The mean score on the knowledge quiz for overdose recognition and response items was 16.2 out of 18, and 1.5 out of 2 possible points for items concerning the law. Respondents indicating professional interest were significantly more likely to be 35 or older (p = .001) and to have received prior overdose education (p < .001), but less likely to know someone at risk for opioid overdose (p < .001) or report planning to obtain take-home naloxone (p < .001). No significant differences were found in overdose knowledge scores between groups.

CONCLUSIONS:

Online training may be effective among individuals with professional and personal interest in overdose, as general knowledge scores of overdose response were high among both groups. Lower scores reflecting knowledge of the law suggest that the web-based training may not have adequately presented this information. Overall, results suggest that a web-based platform may be a promising approach to basic overdose education.

Purchase full article at:   http://goo.gl/z6fX0d

By:   Roe SS¹, Banta-Green CJ².

¹ Social Development Research Group , University of Washington , Seattle , Washington , USA.

² Alcohol and Drug Abuse Institute , University of Washington , Seattle , Washington , USA.

DOI:

10.3109/10826084.2015.1092986

 

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Reach for Me: Fighting to End the American Drug Overdose Epidemic

More at:  http://www.reach4me.org/

Handout for California Pharmacists for Take-Home Naloxone

Via:   http://goo.gl/UUT9XJ