Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States - PubMed (original) (raw)

Comparative Study

Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States

Traci C Green et al. Addiction. 2008 Jun.

Abstract

Aims: This study assessed overdose and naloxone administration knowledge among current or former opioid abusers trained and untrained in overdose-response in the United States.

Design and participants: Ten individuals, divided equally between those trained or not trained in overdose recognition and response, were recruited from each of six sites (n = 62).

Setting: US-based overdose training and naloxone distribution programs in Baltimore, San Francisco, Chicago, New York and New Mexico.

Measurements: Participants completed a brief questionnaire on overdose knowledge that included the task of rating 16 putative overdose scenarios for: (i) whether an overdose was occurring and (ii) if naloxone was indicated. Bivariate and multivariable analyses compared results for those trained to untrained. Responses were also compared to those of 11 medical experts using weighted and unweighted kappa statistics.

Findings: Respondents were primarily male (72.6%); 45.8% had experienced an overdose and 72% had ever witnessed an overdose. Trained participants recognized more opioid overdose scenarios accurately (t(60) = 3.76, P < 0.001) and instances where naloxone was indicated (t(59) = 2.2, P < 0.05) than did untrained participants. Receipt of training and higher perceived competency in recognizing signs of an opioid overdose were associated independently with higher overdose recognition scores. Trained respondents were as skilled as medical experts in recognizing opioid overdose situations (weighted kappa = 0.85) and when naloxone was indicated (kappa = 1.0).

Conclusions: Results suggest that naloxone training programs in the United States improve participants' ability to recognize and respond to opioid overdoses in the community. Drug users with overdose training and confidence in their abilities to respond may effectively prevent overdose mortality.

PubMed Disclaimer

Figures

Figure 1

Figure 1

One of many community-based naloxone distribution and overdose prevention training programs held across the state of New Mexico. Photo courtesy of Philip Fiuty

Figure 2

Figure 2

Time since last reported overdose–response by participants’ overdose–response training history

Similar articles

Cited by

References

    1. Latkin CA, Hua W, Tobin K. Social network correlates of self-reported non-fatal overdose. Drug Alcohol Depend. 2004;73:61–67. - PubMed
    1. Sporer KA. Acute heroin overdose. Ann Intern Med. 1999;130:584–590. - PubMed
    1. Centers for Disease Control and Prevention. Unintentional poisoning deaths—United States, 1999–2004. MMWR. 2007;56:93–96. - PubMed
    1. Garfield J, Drucker E. Fatal overdose trends in major US cities: 1990–1997. Addict Res Theory. 2001;9:425–436.
    1. Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol Drug Saf. 2006;15:618–627. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources