Opioid Education and Naloxone Distribution by Occupation: A Scoping Review.

Abstract

Background: In the U.S., opioid-involved overdose deaths rose dramatically from 21,089 in 2010 to 108,000 in 2022. Opioid use and overdoses are increasingly occurring outside clinical settings, necessitating the need for workplace-based interventions. Various industries, including hospitality and service, have reported increased naloxone training to combat workplace overdoses. This study explores the literature on Opioid Education and Naloxone Distribution (OEND) training by occupation and identifies areas for future intervention through an occupational health lens.

Methods: This scoping review followed the PRISMA-ScR guidelines and utilized Arksey and O'Malley's five-step framework. A comprehensive literature search was conducted across multiple databases, covering publications from January 1, 2011, to December 31, 2023. Studies were included if they reported on the occupational demographics of OEND program participants and the impact of these programs on knowledge, attitudes, and overdose response.

Results: Seventy-five studies met the inclusion criteria. Most OEND training targeted healthcare providers (71%) and first responders (24%). Other occupational groups, such as service industry workers, construction workers, and librarians, were underrepresented. The review highlighted the need for tailored OEND training in these sectors, emphasizing pragmatic implementation measures.

Conclusions: Increased access to naloxone and comprehensive OEND training are crucial for reducing opioid-related overdose mortality, particularly in non-traditional occupational groups.

Application to practice: Occupational health nurses should prioritize expanding OEND programs to underrepresented occupational groups. Tailored training and harm reduction strategies should be incorporated to address the unique needs of these workers and enhance the effectiveness of overdose response interventions in various workplace settings.