Characteristics of an Overdose Prevention, Response, and Naloxone Distribution Program in Pittsburgh and Allegheny County, Pennsylvania

Abstract

Prevention Point Pittsburgh (PPP) is a public health advocacy organization that operates Allegheny County's only needle exchange program. In 2002, PPP implemented an Overdose Prevention Program (OPP) in response to an increase in heroin-related and opioid-related overdose fatalities in the region. In 2005, the OPP augmented overdose prevention and response trainings to include naloxone training and prescription. The objective of our study is to describe the experiences of 426 individuals who participated in the OPP between July 1, 2005, and December 31, 2008. Of these, 89 individuals reported administering naloxone in response to an overdose in a total of 249 separate overdose episodes. Of these 249 overdose episodes in which naloxone was administered, participants reported 96% were reversed. The data support findings from a growing body of research on similar programs in other cities. Community-based OPPs that equip drug users with skills to identify and respond to an overdose and prescribe naloxone can help users and their peers prevent and reverse potentially fatal overdoses without significant adverse consequences.

Process evaluation of the Prevent Overdose in Toronto (POINT) program

“…Similar to the case in other naloxone programs, the refills were provided most commonly because the client's naloxone supply had been used in a reported overdose event. 7,22,24 The other reasons for refills were similar to reasons reported by other programs, such as having been lost, stolen or confiscated. 7,22,24 There were very few deaths among individuals who received naloxone administered by a peer, which corresponds to the literature (83%-100% survival).…”

“…7,22,24 The other reasons for refills were similar to reasons reported by other programs, such as having been lost, stolen or confiscated. 7,22,24 There were very few deaths among individuals who received naloxone administered by a peer, which corresponds to the literature (83%-100% survival). 7,10 Several interesting findings emerged from the detailed descriptions of overdose events.…”

What is known about community pharmacy supply of naloxone? A scoping review

“…Naloxone has been used for more than 40 years to reverse the effects of opioids in clinical and medical settings. Supply of naloxone for bystander administration is more recently becoming a well-established practice in the United States, Canada and the United Kingdom, with numerous studies and reviews confirming the feasibility, efficacy and cost-effectiveness of such programmes (Bennett, Bell, Tomedi, Hulsey, & Kral, 2011;Clark, Wilder, & Winstanley, 2014;Coffin & Sullivan, 2013;Giglio, Li, & DiMaggio, 2015;Walley, et al, 2013).…”

Community use of naloxone for opioid overdose

“…11 This is in addition to numerous international studies that have shown that supplying naloxone for layperson administration is safe, feasible and cost-effective. [12][13][14][15][16] The World Health Organization now recommends naloxone as a strategy to reduce overdose deaths.…”