Wagner Karla D, Bovet L James, Haynes Bruce, Joshua Alfred, Davidson Peter J
Division of Global Public Health, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
San Diego Sheriff's Department, P.O. Box 939062, San Diego, CA 92193, USA.
Drug Alcohol Depend. 2016 Aug 1;165:22-8. doi: 10.1016/j.drugalcdep.2016.05.008. Epub 2016 May 18.
Training law enforcement officers (LEOs) to administer naloxone to opioid overdose victims is increasingly part of comprehensive efforts to reduce opioid overdose deaths. Such efforts could yield positive interactions between LEOs and community members and might ultimately help lower overdose death rates.
We evaluated a pilot LEO naloxone program by (1) assessing opioid overdose knowledge and attitudes (competency in responding, concerns about naloxone administration, and attitudes towards overdose victims) before and after a 30min training on overdose and naloxone administration, and (2) conducting qualitative interviews with LEOs who used naloxone to respond to overdose emergencies after the training.
Eighty-one LEOs provided pre- and post-training data. Nearly all (89%) had responded to an overdose while serving as an LEO. Statistically significant increases were observed in nearly all items measuring opioid overdose knowledge (p's=0.04 to <0.0001). Opioid overdose competencies (p<0.001) and concerns about naloxone administration (p<0.001) significantly improved after the training, while there was no change in attitudes towards overdose victims (p=0.90). LEOs administered naloxone 11 times; nine victims survived and three of the nine surviving victims made at least one visit to substance abuse treatment as a result of a LEO-provided referral. Qualitative data suggest that LEOs had generally positive experiences when they employed the skills from the training.
Training LEOs in naloxone administration can increase knowledge and confidence in managing opioid overdose emergencies. Perhaps most importantly, training LEOs to respond to opioid overdose emergencies may have positive effects for LEOs and overdose victims.
培训执法人员(LEO)向阿片类药物过量受害者注射纳洛酮,日益成为减少阿片类药物过量死亡综合措施的一部分。此类措施可能会在执法人员与社区成员之间产生积极互动,并最终有助于降低过量死亡率。
我们对一项执法人员纳洛酮试点项目进行了评估,方法如下:(1)在进行30分钟的过量用药及纳洛酮注射培训前后,评估执法人员对阿片类药物过量的知识和态度(应对能力、对注射纳洛酮的担忧以及对过量用药受害者的态度);(2)对培训后使用纳洛酮应对过量用药紧急情况的执法人员进行定性访谈。
81名执法人员提供了培训前后的数据。几乎所有执法人员(89%)在担任执法人员期间都曾应对过过量用药情况。在几乎所有衡量阿片类药物过量知识的项目中,均观察到有统计学意义的增长(p值范围为0.04至<0.0001)。培训后,阿片类药物过量应对能力(p<0.001)和对注射纳洛酮的担忧(p<0.001)有显著改善,而对过量用药受害者的态度没有变化(p=0.90)。执法人员注射纳洛酮11次;9名受害者存活,9名存活受害者中有3人因执法人员提供的转介服务,至少前往接受了一次药物滥用治疗。定性数据表明,执法人员运用培训所学技能时,总体体验良好。
培训执法人员注射纳洛酮可增加其应对阿片类药物过量紧急情况的知识和信心。或许最重要的是,培训执法人员应对阿片类药物过量紧急情况可能会对执法人员和过量用药受害者产生积极影响。