Prescription Naloxone: A Novel Approach to Heroin Overdose Prevention

Sporer, Karl A.; Kral, Alex H.

doi:10.1016/j.annemergmed.2006.05.025

Cited by 107 publications

(75 citation statements)

References 71 publications

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“…[5][6][7] A fairly robust research literature that addresses training those at risk for witnessing an overdose in how to recognize and intervene during an emergency exists. 3,[8][9][10][11] However, much less is known about law enforcement officers' experience and perspectives on overdose. Engaging police in opioid overdose response is critical because they are often the first to arrive at the scene and can provide or enhance effective emergency response, especially in rural and poorly resourced areas.…”

Section: Introductionmentioning

confidence: 99%

Police Officers’ and Paramedics’ Experiences with Overdose and Their Knowledge and Opinions of Washington State’s Drug Overdose–Naloxone–Good Samaritan Law

et al. 2013

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Opioid overdoses are an important public health concern. Concerns about police involvement at overdose events may decrease calls to 911 for emergency medical care thereby increasing the chances than an overdose becomes fatal. To address this concern, Washington State passed a law that provides immunity from drug possession charges and facilitates the availability of take-home-naloxone (the opioid overdose antidote) to bystanders in 2010. To examine the knowledge and opinions regarding opioid overdoses and this new law, police (n=251) and paramedics (n=28) in Seattle, WA were surveyed. The majority of police (64 %) and paramedics (89 %) had been at an opioid overdose in the prior year. Few officers (16 %) or paramedics (7 %) were aware of the new law. While arrests at overdose scenes were rare, drugs or paraphernalia were confiscated at 25 % of the most recent overdoses police responded to. Three quarters of officers felt it was important they were at the scene of an overdose to protect medical personnel, and a minority, 34 %, indicated it was important they were present for the purpose of enforcing laws. Police opinions about the immunity and naloxone provisions of the law were split, and we present a summary of the reasons for their opinions. The results of this survey were utilized in public health efforts by the police department which developed a roll call training video shown to all patrol officers. Knowledge of the law was low, and opinions of it were mixed; however, police were concerned about the issue of opioid overdose and willing to implement agency-wide training.

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Section: Introductionmentioning

confidence: 99%

Police Officers’ and Paramedics’ Experiences with Overdose and Their Knowledge and Opinions of Washington State’s Drug Overdose–Naloxone–Good Samaritan Law

et al. 2013

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“…rescue breathing and/or administration of naloxone hydrochloride (hereafter naloxone), a shortacting opioid antagonist. Appropriate responses by bystanders require training in overdose recognition and rescue breathing, as well opioid overdose victim [13].…”

mentioning

confidence: 99%

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States

2008

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Aims-This study assessed overdose and naloxone administration knowledge among current or former opioid abusers trained and untrained in overdose-response in the United States.Design and participants-Ten individuals, divided equally between those trained or not trained in overdose recognition and response, were recruited from each of six sites (n = 62).Setting-US-based overdose training and naloxone distribution programs in Baltimore, San Francisco, Chicago, New York and New Mexico.Measurements-Participants completed a brief questionnaire on overdose knowledge that included the task of rating 16 putative overdose scenarios for: (i) whether an overdose was occurring and (ii) if naloxone was indicated. Bivariate and multivariable analyses compared results for those trained to untrained. Responses were also compared to those of 11 medical experts using weighted and unweighted kappa statistics.Findings-Respondents were primarily male (72.6%); 45.8% had experienced an overdose and 72% had ever witnessed an overdose. Trained participants recognized more opioid overdose scenarios accurately (t 60 = 3.76, P < 0.001) and instances where naloxone was indicated (t 59 = 2.2, P < 0.05) than did untrained participants. Receipt of training and higher perceived competency in recognizing signs of an opioid overdose were associated independently with higher overdose recognition scores. Trained respondents were as skilled as medical experts in recognizing opioid overdose situations (weighted kappa = 0.85) and when naloxone was indicated (kappa = 1.0). Conclusions-Resultssuggest that naloxone training programs in the United States improve participants' ability to recognize and respond to opioid overdoses in the community. Drug users with overdose training and confidence in their abilities to respond may effectively prevent overdose mortality.

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“…1,[5][6][7] Naloxone distribution for peer administration (hereafter referred to as peer naloxone distribution) has been suggested as a strategy to prevent fatal overdose 2,[7][8][9] and has been implemented in countries including Italy, Germany, England, and the United States. 10,11 It has been estimated that the introduction of such programs had saved more than 900 lives by February 2006. 10 While IDU have generally been shown to have positive attitudes toward peer naloxone distribution, 2,6,[12][13][14] concerns have been raised about programs for a variety of reasons including a potential for increased heroin use and the promotion of drug use, 2,6,[15][16][17] questions about the competence of IDU to effectively administer the drug, 9,15 possible adverse reactions, 2,16 and a possible failure to seek subsequent emergency medical support after treatment.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 It has been estimated that the introduction of such programs had saved more than 900 lives by February 2006. 10 While IDU have generally been shown to have positive attitudes toward peer naloxone distribution, 2,6,[12][13][14] concerns have been raised about programs for a variety of reasons including a potential for increased heroin use and the promotion of drug use, 2,6,[15][16][17] questions about the competence of IDU to effectively administer the drug, 9,15 possible adverse reactions, 2,16 and a possible failure to seek subsequent emergency medical support after treatment. 6,12,18 There have been recommendations for the establishment of naloxone distribution programs in Australia.…”

Section: Introductionmentioning

confidence: 99%

Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration

et al. 2008

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Naloxone distribution to injecting drug users (IDUs) for peer administration is a suggested strategy to prevent fatal heroin overdose. The aim of this study was to explore attitudes of IDUs to administration of naloxone to others after heroin overdose, and preferences for method of administration. A sample of 99 IDUs (median age 35 years, 72% male) recruited from needle and syringe programs in Melbourne were administered a questionnaire. Data collected included demographics, attitudes to naloxone distribution, and preferences for method of administration. The primary study outcomes were attitudes of IDUs to use of naloxone for peer administration (categorized on a five-point scale ranging from "very good idea" to "very bad idea") and preferred mode of administration (intravenous, intramuscular, and intranasal). The majority of the sample reported positive attitudes toward naloxone distribution (good to very good idea: 89%) and 92% said they were willing to participate in a related training program. Some participants raised concerns about peer administration including the competence of IDUs to administer naloxone in an emergency, victim response on wakening and legal implications. Most (74%) preferred intranasal administration in comparison to other administration methods (21%). There was no association with age, sex, or heroin practice. There appears to be strong support among Australian IDU for naloxone distribution to peers. Intranasal spray is the preferred route of administration.

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Prescription Naloxone: A Novel Approach to Heroin Overdose Prevention

Cited by 107 publications

References 71 publications

Police Officers’ and Paramedics’ Experiences with Overdose and Their Knowledge and Opinions of Washington State’s Drug Overdose–Naloxone–Good Samaritan Law

Police Officers’ and Paramedics’ Experiences with Overdose and Their Knowledge and Opinions of Washington State’s Drug Overdose–Naloxone–Good Samaritan Law

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States

Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration

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