Overdose and take‐home naloxone in emergency settings: A pilot study examining feasibility of delivering brief interventions addressing overdose prevention with ‘take‐home naloxone’ in emergency departments
- 12 January 2022
- journal article
- research article
- Published by Wiley in Emergency Medicine Australasia
- Vol. 34 (4), 509-518
- https://doi.org/10.1111/1742-6723.13925
Abstract
Objective Although most unintentional opioid deaths in Australia are attributed to pharmaceutical opioids, take-home naloxone (THN) programmes have to date predominantly targeted people using illicit opioids in drug treatment and harm reduction settings. We sought to examine the feasibility of delivering THN brief interventions (THN-BIs) with intranasal naloxone in EDs. Methods This pilot feasibility study was conducted across three major metropolitan EDs in Sydney and Melbourne. ED staff were surveyed about their perspectives regarding THN before completing a 30-min training programme in THN-BI delivery. Patients presenting with opioid overdose or considered high risk for future overdose were eligible to receive the THN-BI. Staff survey responses were compared between hospitals and provider types using one-way analysis of variances. Patient demographic and clinical characteristics were extracted from medical records and compared between hospitals and overdose type using Fisher's exact test and one-way analysis of variances. Results One hundred and twenty-two ED staff completed the survey. One hundred and ten (90.2%) agreed that EDs should provide THN-BIs, whereas 23 (19.2%) identified time constraints and 17 (12.9%) felt uncomfortable discussing overdose with patients. Fifty-seven patients received the THN-BI, with the majority (n = 50, 87.7%) having presented following opioid overdose. The median age was 44 years and 40 (71.4%) were men. Two-thirds of the overdoses (n = 31, 66.0%) were attributed to heroin with one-third (n = 16, 34%) being attributed to pharmaceutical opioids. Conclusions ED-based delivery of THN-BIs can reach a wide range of individuals at-risk of overdose. The present study supports the feasibility of THN interventions in EDs and underscores the importance of addressing implementation barriers including staff training.Keywords
Funding Information
- Mundipharma International
This publication has 27 references indexed in Scilit:
- Factors Associated With Participation in an Emergency Department–Based Take-Home Naloxone Program for At-Risk Opioid UsersAnnals of Emergency Medicine, 2017
- Understanding Risk Factors for Opioid Overdose in Clinical Populations to Inform Treatment and PolicyJournal of Addiction Medicine, 2016
- Understanding opioid overdose characteristics involving prescription and illicit opioids: A mixed methods analysisDrug and Alcohol Dependence, 2016
- Findings and lessons learnt from implementing Australia's first health service based take‐home naloxone programDrug and Alcohol Review, 2016
- Are take‐home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteriaAddiction, 2016
- Exploring the life-saving potential of naloxone: A systematic review and descriptive meta-analysis of take home naloxone (THN) programmes for opioid usersInternational Journal of Drug Policy, 2015
- Emergency department utilization and subsequent prescription drug overdose deathAnnals of Epidemiology, 2015
- Association between non-fatal opioid overdose and encounters with healthcare and criminal justice systems: Identifying opportunities for interventionDrug and Alcohol Dependence, 2015
- Development of Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales for take-home naloxone training evaluationDrug and Alcohol Dependence, 2013
- Estimating the costs of drug‐related hospital separations in AustraliaAustralian and New Zealand Journal of Public Health, 2008