Lott David C, Rhodes Jonathan
Addiction Treatment Programs, Linden Oaks Hospital at Edward-Elmhurst Healthcare, Naperville, Illinois.
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois.
Am J Addict. 2016 Apr;25(3):221-6. doi: 10.1111/ajad.12364. Epub 2016 Mar 22.
Opioid users in treatment are at high risk of relapse and overdose, making them an important target for efforts to reduce opioid overdose mortality. Overdose Education (OE) is one such intervention, and this study tests the effectiveness of OE in a community substance use disorder treatment program.
Opioid users were recruited from a community treatment center for the study. The Opioid Overdose Knowledge Scale (OOKS) was administered before and after an educational intervention (small group lecture, slideshow, and handout based on previously published content) to assess knowledge of the risks, signs, and actions associated with opioid overdose, including use of naloxone. Additional survey questions assessed naloxone access, naloxone education, and overdose experiences at treatment and 3-month follow-up. Subjects (n = 43) were 28% female and had a mean age of 31 years. OOKS scores were compared at pre-intervention, post-intervention, and follow-up, and results were also compared with a historical non-intervention control group (n = 14).
Total score on the OOKS increased significantly from pre- to post-education, and improvement was maintained at follow-up (p < .0001). OOKS subdomains of actions and naloxone use also had significant increases (p < .0001). Four subjects reported possessing naloxone in the past, and only one subject who did not already have naloxone at the time of treatment had obtained it at follow-up.
Education about opioid overdose and naloxone use in a community treatment program increases overdose knowledge, providing support for the idea of making OE a routine part of substance use disorder treatment. However, the rate of follow through on accessing naloxone was low with this education-only intervention.
接受治疗的阿片类药物使用者有很高的复发和过量用药风险,这使他们成为降低阿片类药物过量死亡率努力的重要目标。过量用药教育(OE)就是这样一种干预措施,本研究测试了OE在社区物质使用障碍治疗项目中的有效性。
从社区治疗中心招募阿片类药物使用者参与研究。在一次教育干预(基于先前发表内容的小组讲座、幻灯片展示和手册)前后,使用阿片类药物过量知识量表(OOKS)来评估与阿片类药物过量相关的风险、体征及应对措施的知识,包括纳洛酮的使用。另外的调查问题评估了纳洛酮的获取情况、纳洛酮教育以及治疗时和3个月随访时的过量用药经历。受试者(n = 43)中28%为女性,平均年龄31岁。比较干预前、干预后及随访时的OOKS分数,结果也与一个历史非干预对照组(n = 14)进行比较。
OOKS的总分从教育前到教育后显著增加,且在随访时仍保持改善(p <.0001)。行动和纳洛酮使用的OOKS子领域也有显著增加(p <.0001)。4名受试者报告过去拥有纳洛酮,治疗时没有纳洛酮的受试者中只有1名在随访时获得了纳洛酮。
在社区治疗项目中开展关于阿片类药物过量和纳洛酮使用的教育可增加过量用药知识,为将OE作为物质使用障碍治疗常规部分的观点提供了支持。然而,仅通过这种教育干预获取纳洛酮的后续跟进率较低。