Characterizing Individuals Who Elect and Decline Opioid Overdose Education and Naloxone Distribution to Tailor Programs and Expand Impact.

IF 4.2 3区医学 Q1 SUBSTANCE ABUSE

Journal of Addiction Medicine Pub Date : 2024-11-08 DOI:10.1097/ADM.0000000000001407

Michelle L Sisson, Andres Azuero, Elizabeth Hawes, Keith R Chichester, Matthew J Carpenter, Michael S Businelle, Richard C Shelton, Karen L Cropsey

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引用次数: 0

Abstract

Background: In response to the opioid epidemic, federal agencies have stressed the importance of targeted naloxone distribution through avenues such as Opioid Overdose Education and Naloxone Distribution (OEND). OEND effectively reduces mortality by training laypersons to respond to overdose situations. Despite demonstrated effectiveness, OEND remains underutilized. This project aimed to characterize those who illicitly use opioids to determine avenues for future tailoring of OEND programs.

Methods: Individuals who illicitly used opioids within the past 6 months were recruited via online social media. Participants completed an online questionnaire that assessed history of opioid use and were given the option to receive opioid overdose and naloxone administration training. Those who elected training (n = 111) and those who declined (n = 193) were compared on opioid use, severity of use, and overdose experiences.

Results: Participants (N = 304) were 47% male and 83% White. Tests of between group differences with measures of effect size were used for analyses. Those who elected training endorsed greater intravenous administration (χ2 = 4.18, P = 0.041, Cramer's V = 0.12). Individuals who declined training reported more frequent nonprescribed methadone use (χ2 = 7.51, P = 0.006, Cramer's V = 0.16), overdose hospitalizations (t(298) = 2.13, P = 0.034, Cohen's d = 0.26), and observed overdoses (t(300) = 3.01, P = 0.003, Cohen's d = 0.36). After adjusting for multiple comparisons, only the differences in nonprescribed methadone use and observed overdoses remained statistically significant.

Conclusions: Individuals who declined training were more likely to report ever use of nonprescribed methadone and having witnessed others overdose. They may have had greater exposure to naloxone, hence decreasing perceived need for training. Understanding characteristics of those who elect and refuse training could inform structuring of programs and recruitment approaches.

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确定选择和拒绝阿片类药物过量教育和纳洛酮发放的个人特征，以调整计划并扩大影响。

背景：为应对阿片类药物的流行，联邦机构强调了通过阿片类药物过量教育和纳洛酮分发（OEND）等途径有针对性地分发纳洛酮的重要性。OEND 通过培训非专业人员应对用药过量情况，有效降低了死亡率。尽管效果显著，但 OEND 仍未得到充分利用。本项目旨在了解非法使用阿片类药物者的特征，以确定未来调整 OEND 项目的途径：方法：通过在线社交媒体招募在过去 6 个月内非法使用过阿片类药物的个人。参与者填写了一份评估阿片类药物使用史的在线问卷，并可选择接受阿片类药物过量和纳洛酮管理培训。对选择培训者（n = 111）和拒绝培训者（n = 193）进行了阿片类药物使用、使用严重程度和用药过量经历方面的比较：结果：参与者（N = 304）中 47% 为男性，83% 为白人。分析采用了组间差异检验和效应大小测量。选择接受培训的人认可更多的静脉注射（χ2 = 4.18，P = 0.041，Cramer's V = 0.12）。拒绝培训的人报告了更频繁的非处方美沙酮使用（χ2 = 7.51，P = 0.006，Cramer's V = 0.16）、用药过量住院（t(298) = 2.13，P = 0.034，Cohen's d = 0.26）和观察到的用药过量（t(300) = 3.01，P = 0.003，Cohen's d = 0.36）。经多重比较调整后，只有非处方美沙酮使用量和观察到的过量用药量的差异仍具有统计学意义：结论：拒绝接受培训的人更有可能报告曾经使用过无处方美沙酮和目睹过他人用药过量。他们可能接触过更多纳洛酮，因此对培训的需求减少。了解选择和拒绝培训者的特征可以为计划的构建和招募方法提供参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Addiction Medicine 医学-药物滥用

CiteScore

6.10

自引率

9.10%

发文量

260

审稿时长

>12 weeks

期刊介绍： The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.