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.
Drug Alcohol Depend. 2023 Aug 1;249:110815. doi: 10.1016/j.drugalcdep.2023.110815. Epub 2023 Jun 7.
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.
尽管阿片类药物过量教育和纳洛酮分发（OEND）项目已显示出其价值，但采用率和利用率仍然很低。获得OEND的机会有限，传统项目可能无法覆盖许多高危个体。本研究评估了在线阿片类药物过量及纳洛酮给药教育的有效性以及持有纳洛酮的影响。
通过克雷格列表网站上的广告招募自我报告有阿片类药物非法使用情况的个体，并通过REDCap在线完成所有评估和教育。参与者观看了一段20分钟的视频，视频概述了阿片类药物过量的迹象以及如何使用纳洛酮。然后将他们随机分为两组，一组接受纳洛酮试剂盒，另一组得到关于何处获取试剂盒的指导。通过培训前后的知识问卷来衡量培训的有效性。在每月的随访评估中，由参与者自我报告纳洛酮试剂盒持有情况、过量用药情况、阿片类药物使用频率和治疗意愿。
培训后平均知识得分从6.82/9.00显著提高到8.22（t(194)=6.85，p<0.001，95%CI[1.00, 1.81]，科恩d值=0.85）。随机分组之间纳洛酮持有情况的差异具有显著性，效应量较大（p<0.001，差异=0.60，95%CI[0.47, 0.73]）。发现纳洛酮持有情况与阿片类药物使用频率之间存在双向关系。不同持有状态下的过量用药情况和治疗意愿相似。
过量用药教育以在线视频形式是有效的。不同组之间纳洛酮持有情况的差异表明从药店获取纳洛酮存在障碍。持有纳洛酮并未影响危险的阿片类药物使用或治疗意愿，其对使用频率的影响值得进一步研究。
Clinicaltrials.gov - NCT04303000。
