A Study on the Efficacy of a Naloxone Training Program

Abstract

Introduction: The use of naloxone to reverse a potentially fatal opioid overdose is a harm reduction strategy that reduces mortality and increases the potential for referral to substance use treatment for affected individuals. In the setting of outreach performed by a street medicine team, we aimed to determine the effectiveness of an educational intervention involving distribution of naloxone accompanied by a brief instructive session about opioids, opioid overdose, and medication administration. Methods: Our street medicine outreach team distributed 200 naloxone kits to clinicians and volunteers involved in caring for patients on ‘street rounds,’ as well as in shelters, soup kitchens, and street medicine clinic settings. Those receiving a naloxone kit engaged in a peer-reviewed presentation on how to safely use the medication to reverse a potentially fatal opioid overdose. The study team developed and administered a pre- and post-survey of 10 multiple choice questions on material covered in the educational training. The pre- and post-survey scores were compared to assess the effectiveness of implementing this training. Results were stratified by participant gender and age group. Results: Out of the 200 participants, six were excluded from the analysis due to completely missing data from one or both surveys. The mean age of participants was 40.2±12.5 years; 120 (65.6%) were female, 62 (33.9%) were male, and 1 (0.6%) identified as nonbinary. Every survey question had an increase in correct responses from pre-survey to post-survey (identified by an increase in the percentage of correct responses). The mean survey total score increased from 5.5±1.6 to 7.5±1.3. Within the sample of 194, the mean difference in scores from pre-survey to post-survey was 2.02 points (95% CI [1.77, 2.26]), p<0.0001. Males had a mean increase in the total score from 5.6±1.8 to 7.4±1.1. Females had a mean increase in the total score from 5.5±1.5 to 7.5±1.3. The difference in total scores in males was 1.89 points (95% CI [1.42, 2.35]), p<0.0001, and in females was 2.02 points (95% CI [1.71, 2.32]), p<0.0001. Post-test scores improved in all age groups. Conclusion: The educational training on opioids, opioid overdose, and the use of naloxone was an effective adjunct to naloxone kit distribution to volunteers and clinicians caring for people experiencing homelessness.

The Role of Street Medicine and Mobile Clinics for Persons Experiencing Homelessness: A Scoping Review

“…The UMass Memorial Medical Center mobile clinic reported prescribing buprenorphine to 330 individuals, and their naloxone distribution reported 74 rescue attempts [ 31 ]. In fact, naloxone distribution was reported by multiple organizations [ 31 , 37 ]. One street medicine team also reported providing and evaluating education on how to use naloxone [ 37 ].…”

The Effect of Postoperative Naloxone in Certain Otolaryngologic Surgeries

“…These include geographic region (rural vs suburban vs urban), access to emergency medical services, prior experiences in the penal system, and fear of retribution. 24,25 These factors were unable to be assessed in our analysis but may have impacted our data.…”

“…While we attempted to control for demographic factors such as age and sex and excluded patients from analysis who had prior instances of SUD or overdose documented in their chart, there are other social factors that influence patterns of opioid consumption and naloxone use. These include geographic region (rural vs suburban vs urban), access to emergency medical services, prior experiences in the penal system, and fear of retribution 24,25 . These factors were unable to be assessed in our analysis but may have impacted our data.…”

ReportNeedles.ca: A real-time needle collection tool to foster community health partnerships

“…Naloxone training is a brief, educational harm reduction intervention comprised of distribution of naloxone alongside information about opioids, safer drug use, overdose risk and symptoms, and medication administration. [17][18][19] These trainings have been found to significantly increase knowledge regarding safer substance use amongst people who use drugs, service providers, and the public. [17][18][19] Naloxone can reverse a potentially fatal opioid overdose and can be administered by anyone, [17][18][19] however training is required to ensure proper implementation.…”

“…[17][18][19] These trainings have been found to significantly increase knowledge regarding safer substance use amongst people who use drugs, service providers, and the public. [17][18][19] Naloxone can reverse a potentially fatal opioid overdose and can be administered by anyone, [17][18][19] however training is required to ensure proper implementation. 18 Additionally, harm reduction peer support groups will be offered by APSS to active drug users that focus on psychoeducation, enhancing participant support networks, and knowledge of safer drug use.…”