Opioid Overdose Prevention Training with Naloxone, An Adjunct to Basic Life Support Training for First-Year Medical Students

Abstract

Background Opioid overdose deaths have reached epidemic proportions in the United States. This problem stems from both licit and illicit opioid use. Physicians play a role in prescribing opioids, recognizing risky use, and initiating prevention, including Opioid Overdose Prevention Training (OOPT). The American Heart Association (AHA) modified their basic life support (BLS) algorithms to consider naloxone in high risk populations and when a pulse is appreciated; however, the AHA did not provide OOPT. Our intervention filled this training deficiency by teaching medical students opioid overdose resuscitation with a Train-The-Trainer model as part of mandatory BLS training. Methods We introduced OOPT, following a Train-The-Trainer model, into the required Basic Life Support (BLS) training for first-year medical students at a single medical school in a large urban area. We administered pre- and post-evaluations to assess the effects of the training on opioid overdose knowledge, self-reported preparedness to respond to opioid overdoses, and attitudes towards patients with SUDS. Results In the fall 2014, 120 first-year medical students received OOPT. Seventy-three students completed both pre- and post-training evaluations. Improvements in knowledge about and preparedness to respond to opioid overdoses were statistically significant (p <.01) and large (Cohen’s D = 2.70 and Cohen’s D = 2.10 respectively). There was no statistically significant change in attitude toward patients with SUDs. Conclusions We demonstrated the effectiveness of OOPT as an adjunct to BLS in increasing knowledge about and preparedness to respond to opioid overdoses; improving attitudes toward patients with SUDs likely requires additional intervention. We will characterize knowledge and preparedness durability, program sustainability, and long-term changes in attitudes in future evaluations. These results support dissemination of OOPT as a part of BLS training for all medical students, and potentially all BLS providers.

Evaluation of an interprofessional naloxone didactic and skills session with medical residents and physician assistant learners

“…The pilot results of our training model demonstrated improvement in comfort levels administering four different methods of naloxone. Exposure to training, as suggested by others, in addition to personal experiences with patients and/or family members can impact necessary changes in behaviors and attitudes toward providing access to naloxone for patients who would benefit most 28,29…”

Changing Prescribing Behavior in the United States: Moving Upstream in Opioid Prescription Education

“…In 2016, the Pennsylvania State University College of Medicine implemented a 2‐h interdisciplinary session for second‐year undergraduate medical students on opioid addiction, with positive evaluations by students (a mean rating of “4” on a 5‐point scale) . Finally, in 2016 the New York University School of Medicine implemented an opioid overdose resuscitation session for first‐year medical students as part of their required Basic Life Support training, with significantly positive improvements in knowledge and preparedness to respond to opioid overdoses …”

Get waivered remote: Nationwide, remote DEA-x waiver course in response to COVID-19

“…Training related to both the prevention and treatment of opioid overdose with the use of evidence-based prescribing practices leads to improvements in clinician preparedness to address OUD. 6 , 7 To treat OUD with buprenorphine, clinicians must undergo additional training to receive an “X” waiver from the DEA, 5 yet despite the documented efficacy of MAT, less than five percent of physicians in the United States had obtained an “X” waiver certifying them to prescribe buprenorphine prior to the emergence of COVID-19. 8 Physicians obtain this waiver by completing an 8-h course while nurse practitioners and physician assistants are required to complete a 24-h course.…”