Sisson Michelle L, Azuero Andres, Chichester Keith R, Carpenter Matthew J, Businelle Michael S, Shelton Richard C, Cropsey Karen L
Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Nursing, Family, Community & Health Systems, University of Alabama at Birmingham, Birmingham, AL, USA.
Contemp Clin Trials Commun. 2023 Apr 5;33:101131. doi: 10.1016/j.conctc.2023.101131. eCollection 2023 Jun.
Drug overdose is the leading cause of accidental death in the United States, with over 70% of drug related fatalities resulting from the use of opioids. Federal agencies have responded to this crisis with various recommendations including enhancing harm reduction approaches such as training laypersons to administer naloxone through Opioid Overdose Education and Naloxone Distribution (OEND) programs. Several studies have demonstrated that OEND programs effectively reduce opioid overdose mortality and are both safe and cost-effective, however, they are typically implemented in urban areas as part of large medical center research programs, needle exchanges, or drug treatment programs. Individuals living in areas without these programs or services lack access to critical and life-saving OEND. The current study examined the acceptability and feasibility of online recruitment, online opioid overdose education, and remote distribution of naloxone kits. Persons who illicitly use opioids and are at risk for overdose were recruited through online media and completed an opioid use questionnaire. If interested in receiving opioid overdose and naloxone administration training, participants completed pre- and post-intervention knowledge questionnaires, engaged in audiovisual training, and were randomized to either receive a naloxone kit or be given information on where they could obtain one. Preliminary results indicate feasibility and acceptability as evidenced by strong recruitment and retention, as well as high participant satisfaction ratings. Successful implementation of remote OEND through this project supports future employment of similar remote programs to expand this critical harm reduction strategy to high-risk individuals in areas lacking traditional OEND programs.
TRIAL REGISTRATION #: Clinitaltrials.gov- NCT04303000.
药物过量是美国意外死亡的主要原因，超过70%的药物相关死亡是由使用阿片类药物导致的。联邦机构针对这一危机提出了各种建议，包括加强减少伤害的方法，如通过阿片类药物过量教育和纳洛酮分发（OEND）项目培训非专业人员使用纳洛酮。多项研究表明，OEND项目能有效降低阿片类药物过量死亡率，且安全且具有成本效益。然而，这些项目通常在城市地区实施，作为大型医疗中心研究项目、针头交换项目或药物治疗项目的一部分。生活在没有这些项目或服务地区的个人无法获得关键的救命OEND。本研究考察了在线招募、在线阿片类药物过量教育以及纳洛酮试剂盒远程分发的可接受性和可行性。通过在线媒体招募非法使用阿片类药物且有过量风险的人员，并让他们填写一份阿片类药物使用问卷。如果有兴趣接受阿片类药物过量及纳洛酮使用培训，参与者需完成干预前后的知识问卷，参加视听培训，并被随机分配接受纳洛酮试剂盒或被告知可获取试剂盒的地点。初步结果表明该方法具有可行性和可接受性，招募和留存情况良好以及参与者满意度评分高就是证明。通过该项目成功实施远程OEND，为未来采用类似的远程项目提供了支持，以便将这一关键的减少伤害策略扩展到缺乏传统OEND项目地区的高危个体。
Clinitaltrials.gov - NCT04303000
