Preliminary effectiveness of online opioid overdose and naloxone administration training and impact of naloxone possession on opioid use.


Journal

Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587

Informations de publication

Date de publication:
01 Aug 2023
Historique:
received: 16 12 2022
revised: 29 05 2023
accepted: 31 05 2023
medline: 10 7 2023
pubmed: 19 6 2023
entrez: 19 6 2023
Statut: ppublish

Résumé

Despite the demonstrated value of opioid overdose education and naloxone distribution (OEND) programs, uptake and utilization remains low. Accessibility to OEND is limited and traditional programs may not reach many high-risk individuals. This study evaluated the effectiveness of online opioid overdose and naloxone administration education and the impact of naloxone possession. Individuals with self-reported illicit use of opioids were recruited via Craigslist advertisements and completed all assessments and education online via REDCap. Participants watched a 20-minute video outlining signs of opioid overdose and how to administer naloxone. They were then randomized to either receive a naloxone kit or be given instructions on where to obtain a kit. Effectiveness of training was measured with pre- and post-training knowledge questionnaires. Naloxone kit possession, overdoses, opioid use frequency, and treatment interest were self-reported on monthly follow-up assessments. Mean knowledge scores significantly increased from 6.82/9.00 to 8.22 after training (t(194)=6.85, p <0.001, 95% CI[1.00, 1.81], Cohen's d=0.85). Difference in naloxone possession between randomized groups was significant with a large effect size (p <0.001, diff=0.60, 95% CI[0.47, 0.73]). A bidirectional relationship was found between naloxone possession and frequency of opioid use. Overdoses and treatment interest were similar across possession status. Overdose education is effective in online video format. Disparity in naloxone possession across groups indicates barriers to obtaining naloxone from pharmacies. Naloxone possession did not influence risky opioid use or treatment interest and its impact on frequency of use warrants further investigation. Clinitaltrials.gov-NCT04303000.

Sections du résumé

BACKGROUND BACKGROUND
Despite the demonstrated value of opioid overdose education and naloxone distribution (OEND) programs, uptake and utilization remains low. Accessibility to OEND is limited and traditional programs may not reach many high-risk individuals. This study evaluated the effectiveness of online opioid overdose and naloxone administration education and the impact of naloxone possession.
METHODS METHODS
Individuals with self-reported illicit use of opioids were recruited via Craigslist advertisements and completed all assessments and education online via REDCap. Participants watched a 20-minute video outlining signs of opioid overdose and how to administer naloxone. They were then randomized to either receive a naloxone kit or be given instructions on where to obtain a kit. Effectiveness of training was measured with pre- and post-training knowledge questionnaires. Naloxone kit possession, overdoses, opioid use frequency, and treatment interest were self-reported on monthly follow-up assessments.
RESULTS RESULTS
Mean knowledge scores significantly increased from 6.82/9.00 to 8.22 after training (t(194)=6.85, p <0.001, 95% CI[1.00, 1.81], Cohen's d=0.85). Difference in naloxone possession between randomized groups was significant with a large effect size (p <0.001, diff=0.60, 95% CI[0.47, 0.73]). A bidirectional relationship was found between naloxone possession and frequency of opioid use. Overdoses and treatment interest were similar across possession status.
CONCLUSIONS CONCLUSIONS
Overdose education is effective in online video format. Disparity in naloxone possession across groups indicates barriers to obtaining naloxone from pharmacies. Naloxone possession did not influence risky opioid use or treatment interest and its impact on frequency of use warrants further investigation.
TRIAL REGISTRATION BACKGROUND
Clinitaltrials.gov-NCT04303000.

Identifiants

pubmed: 37336007
pii: S0376-8716(23)01053-0
doi: 10.1016/j.drugalcdep.2023.110815
pii:
doi:

Substances chimiques

Naloxone 36B82AMQ7N
Analgesics, Opioid 0
Narcotic Antagonists 0

Banques de données

ClinicalTrials.gov
['NCT04303000']

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110815

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest Dr. Carpenter has received consulting honoraria from Pfizer and Frutarom Inc. The authors declare that there is no conflict of interest.

Auteurs

Michelle L Sisson (ML)

Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: msisson@uabmc.edu.

Andres Azuero (A)

Department of Nursing, Family, Community & Health Systems, University of Alabama at Birmingham, Birmingham, AL, USA.

Keith R Chichester (KR)

Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Matthew J Carpenter (MJ)

Medical University of South Carolina, Hollings Cancer Center & Department of Psychiatry and Behavioral Sciences, Charleston, SC, USA.

Michael S Businelle (MS)

TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.

Richard C Shelton (RC)

Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

Karen L Cropsey (KL)

Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

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Classifications MeSH