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.

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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.  

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Reducing Fatal Opioid Overdose: Prevention, Treatment & Harm Reduction Strategies

Below: Opportunities to reduce overdose risk by increasing treatment engagement. There are multiple access points for initiatives on an individual, friends and family, community, prescriber, and government level. Medication-assisted treatment augments counseling and behavioral therapies with medications, such as methadone or buprenorphine. Abbreviations: Prescription (Rx), Treatment (Tx), National Institute of Health (NIH), National Institute of Drug Abuse (NIDA), Medication-Assisted Treatment (MAT).

Below: Opportunities to reduce overdose risk through harm reduction strategies. There are multiple access points for initiatives on an individual, friends and family, community, prescriber, and government level. Abbreviations: Food and Drug Administration (FDA); Overdose (OD); Prescription Monitoring Program (PMP), National Institute of Health (NIH), Substance Abuse and Mental Health Services Administration (SAMHSA).

Below: State-by-State Good Samaritan, naloxone liability and third party prescribing laws. Infographic from Office of National Drug Control Policy (ONDCP) website showing which states have passed Good Samaritan, civil and criminal liability protection laws for lay administrator and prescribers, and third party prescribing laws as of December 1, 2014.

The opioid overdose epidemic is a major threat to the public’s health, resulting in the development and implementation of a variety of strategies to reduce fatal overdose [1-3]. Many strategies are focused on primary prevention and increased access to effective treatment, although the past decade has seen an exponential increase in harm reduction initiatives. To maximize identification of opportunities for intervention, initiatives focusing on prevention, access to effective treatment, and harm reduction are examined independently, although considerable overlap exists. Particular attention is given to harm reduction approaches, as increased public and political will have facilitated widespread implementation of several initiatives, including increased distribution of naloxone and policy changes designed to increase bystander assistance during a witnessed overdose [4-7].

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Opioid Overdose Prevention Programs Providing Naloxone to Laypersons: US

Below:  Number of survey respondents reporting beginning or continuing to provide naloxone kits to laypersons, by year — United States, 1996–June 2014

Via: http://ht.ly/OvxKc  MT @CDCMMWR