Does training people to administer take‐home naloxone increase their knowledge? Evidence from Australian programs

Dietze, Paul; Draper, Bridget; Olsen, Anna; Chronister, Karen J.; Beek, Ingrid van; Lintzeris, Nicholas; Dwyer, Robyn; Nelson, Morton; Lenton, Simon

doi:10.1111/dar.12680

Cited by 29 publications

(27 citation statements)

References 15 publications

(22 reference statements)

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“…This emergent difference in overdose prevention strategies by gender suggests that women may be more receptive to interventions aimed to reduce drug use or practice more conservative strategies and diffusion of information may be employed to extend those strategies to men. Increased willingness among females to engage in additional prevention strategies may be compounded by gender differences in the retention of knowledge about strategies, such as that demonstrated by a recent study where female trainees, compared to males, had higher levels of knowledge gained from naloxone training [48].…”

Section: Discussionmentioning

confidence: 99%

Preventing opioid overdose with peer-administered naloxone: findings from a rural state

et al. 2020

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Background: In response to the opioid epidemic, naloxone distribution programs aim to prevent overdose death by making naloxone available and training people to use it. Peers of individuals at risk of opioid overdose are wellpositioned to administer naloxone and prevent overdose death. Methods: We conducted key informant interviews with 18 individuals with past or current opioid and heroin drug use who had administered naloxone to a peer during an overdose emergency. Interviews explored individuals' experiences with administration and their recommendations for program and policy improvement. Data were systematically coded and analyzed for themes. Results: Participants sought naloxone rescue kits because they perceived high risk of overdose. They described high satisfaction with training and felt prepared to administer naloxone during overdose incidents. Overwhelmingly, participants perceived naloxone to be effective and emphasized the need to make it widely available. Findings suggest that engagement in overdose prevention strategies other than naloxone differs by gender, with females more likely than males to use multiple different strategies. Participants described that overdose experiences do not have a lasting impact on drug use behaviors. Conclusions: Findings support the feasibility of naloxone distribution to peer opioid and heroin users and provide recommendations for policy improvement, including effective and well-advertised Good Samaritan laws and links to treatment for opioid use disorder.

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Section: Discussionmentioning

confidence: 99%

Preventing opioid overdose with peer-administered naloxone: findings from a rural state

et al. 2020

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“…Programmes are supported by World Health Organization guidelines [12] and endorsed by the United Nations [13]. Evidence suggests that providing people who use opioids with overdose training increases their knowledge of overdose risk factors, signs and responses [14][15][16][17][18][19], that people who use opioids can and will use naloxone to reverse overdoses when trained [18,[20][21][22] and that naloxone distribution to people who use opioids reduces mortality [23,24] and is cost-effective [25,26]. Despite this, most countries do not have naloxone programmes and countries that do have differing policies, training and provision that can be constrained by national and local legal and regulatory frameworks, as well as costs [27,28].…”

Section: Introductionmentioning

confidence: 99%

How competent are people who use opioids at responding to overdoses? Qualitative analyses of actions and decisions taken during overdose emergencies

et al. 2018

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Background and Aims Providing take-home naloxone (THN) to people who use opioids is an increasingly common strategy for reversing opioid overdose. However, implementation is hindered by doubts regarding the ability of people who use opioids to administer naloxone and respond appropriately to overdoses. We aimed to increase understanding of the competencies required and demonstrated by opioid users who had recently participated in a THN programme and were subsequently confronted with an overdose emergency. Design Qualitative study designed to supplement findings from a randomized controlled trial of overdose education and naloxone distribution. Interviews were audio-recorded, transcribed, systematically coded and analysed via Iterative Categorization. Setting New York City, USA. Participants Thirty-nine people who used opioids (32 men, 7 women; aged 22-58 years). Intervention Trial participants received brief or extended overdose training and injectable or nasal naloxone. Measurements The systematic coding frame comprised deductive codes based on the topic guide and more inductive codes emerging from the data. Findings In 38 of 39 cases the victim was successfully resuscitated; the outcome of one overdose intervention was unknown. Analyses revealed five core overdose response 'tasks': (1) overdose identification; (2) mobilizing support; (3) following basic first aid instructions; (4) naloxone administration; and (5) post-resuscitation management. These tasks comprised actions and decisions that were themselves affected by diverse cognitive, emotional, experiential, interpersonal and social factors over which lay responders often had little control. Despite this, participants demonstrated high levels of competency. They had acquired new skills and knowledge through training and brought critical 'insider' understanding to overdose events and the resuscitation actions which they applied. Conclusions People who use opioids can be trained to respond appropriately to opioid overdoses and thus to save their peers' lives. Overdose response requires both practical competency (e.g. skills and knowledge in administering basic first aid and naloxone) and social competency (e.g. willingness to help others, having the confidence to be authoritative and make decisions, communicating effectively and demonstrating compassion and care to victims post-resuscitation).

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“…The HRVic‐led THN initiatives were independently evaluated over 18 months by researchers at Victoria University and the Burnet Institute. Select evaluation findings are reported elsewhere . To June 2017, 1072 people have been trained by the HRVic peer educator, with 295 successful reversals reported (this figure includes evaluation data and anecdotal reports to HRVic and collaborating services).…”

Section: Take‐home Naloxone In Victoria 2013 To 2017mentioning

confidence: 99%

An overview of take‐home naloxone programs in Australia

Dwyer

Olsen

Fowlie

et al. 2018

Drug and Alcohol Review

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Peer drug user groups currently play a central role in the development, delivery and scale-up of THN in Australia. Health professionals who work with people who use illicit opioids are increasingly taking part as alcohol and other drug-related health agencies have recognised the opportunity for THN provision through interactions with their clients. Australia has made rapid progress in removing regulatory barriers to naloxone since the initiation of the first THN program in 2012. However, logistical and economic barriers remain and further work is needed to expand access to this life-saving medication.

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Does training people to administer take‐home naloxone increase their knowledge? Evidence from Australian programs

Cited by 29 publications

References 15 publications

Preventing opioid overdose with peer-administered naloxone: findings from a rural state

Preventing opioid overdose with peer-administered naloxone: findings from a rural state

How competent are people who use opioids at responding to overdoses? Qualitative analyses of actions and decisions taken during overdose emergencies

An overview of take‐home naloxone programs in Australia

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