Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA.
Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA.
Drug Alcohol Depend. 2022 Aug 1;237:109505. doi: 10.1016/j.drugalcdep.2022.109505. Epub 2022 May 23.
Overdose education and naloxone distribution (OEND) trains people who use opioids (PWUO) in how to intervene in cases of opioid overdose but best practices have not been assessed empirically.
PWUO along with a significant other (SO) were randomized to one of three training conditions. In the Treatment-as-Usual (TAU) condition, participants were randomized to receive minimal overdose-related education. In the extended training (ET) condition, PWUO received an extended training, while their SO received no overdose training. In the final condition, both the participant and SO received the extended overdose training (ETwSO). Outcome measures were naloxone use and overdose knowledge and competency assessed immediately before and after training, and at 1-, 3-, 6-, and 12-month timepoints following training.
Three hundred and twenty-one PWUO (w/ a SO) were randomized. All intensities of OD training were associated with sustained increases in OD knowledge/ competency (versus pre-training baseline p's < 0.01). PWUO intervened in 166 ODs. The 12-month incidence of naloxone use did not significantly differ between groups. Extended training (ET + ETwSO) compared to TAU resulted in significantly greater naloxone utilization by: 30 days (10.1% vs 4.1%, p = 0.041), 60 days (16.4% vs 5.2%, p<0.001) and 90 days (17.9% vs 9.5%, p = 0.039).
All intensities of OD training were associated with sustained increases in OD knowledge and competency, and equivalent rates of successful naloxone use. More extensive training increased naloxone utilization during the first 3 months. However, the benefits of more comprehensive training should be balanced against feasibility.
过量用药教育和纳洛酮分发（OEND）培训使用阿片类药物的人（PWUO）如何干预阿片类药物过量，但最佳实践尚未经过实证评估。
PWUO 及其重要他人（SO）被随机分配到三种培训条件之一。在常规治疗（TAU）条件下，参与者被随机分配接受最低限度的与过量相关的教育。在扩展培训（ET）条件下，PWUO 接受扩展培训，而他们的 SO 没有接受过量培训。在最后一个条件下，参与者和 SO 都接受扩展的过量培训（ETwSO）。结果测量是在培训前后以及培训后 1、3、6 和 12 个月时立即评估纳洛酮的使用和过量知识和能力。
321 名 PWUO（有 SO）被随机分配。所有强度的 OD 培训都与 OD 知识/能力的持续增加相关（与培训前基线相比，p 值均<0.01）。PWUO 干预了 166 例 OD。在 12 个月的时间里，各组之间纳洛酮的使用发生率没有显著差异。与 TAU 相比，扩展培训（ET + ETwSO）导致纳洛酮的使用显著增加：30 天（10.1%比 4.1%，p=0.041），60 天（16.4%比 5.2%，p<0.001）和 90 天（17.9%比 9.5%，p=0.039）。
所有强度的 OD 培训都与 OD 知识和能力的持续增加有关，并且纳洛酮的使用成功率相当。更广泛的培训在头 3 个月增加了纳洛酮的使用。然而，更全面的培训的好处应该与可行性相平衡。
