Evaluation of a personally-tailored opioid overdose prevention education and naloxone distribution intervention to promote harm reduction and treatment readiness in individuals actively using illicit opioids

Drug Alcohol Depend. 2020 Nov 1:216:108265. doi: 10.1016/j.drugalcdep.2020.108265. Epub 2020 Aug 31.

Abstract

Background: Opioid overdose prevention education and naloxone distribution (OEND) programs include information on general risk factors, overdose recognition, and naloxone utilization. This study evaluated a personally-tailored OEND (PTOEND) intervention designed to promote harm reduction and treatment readiness for illicit opioid users by also including education about personal overdose-risk factors and medication for opioid use disorder (MOUD).

Method: A secondary analysis of a randomized controlled trial testing a Peer recovery support service (PRSS) intervention, relative to Control, in adult illicit opioid users reporting treatment for an overdose in the prior 6 months. PTOEND, a 30-minute computer-guided intervention, was administered by a research assistant at the randomization visit to all participants (N = 80). Participants completed a telephone visit 3 weeks post-randomization (n = 74) to assess changes in opioid overdose/MOUD knowledge and treatment readiness. Participants completed in-person visits at 3 (n = 66), 6 (n = 58), and 12 (n = 44) months post-randomization to assess illicit opioid use and naloxone utilization (all time points) and overdose-risk behaviors (12 months). We conducted pre-post analyses of the impact of PTOEND controlling for the PRSS effect.

Results: PTOEND increased knowledge of overdose (79.8% to 81.5%, p < 0.05) and MOUD (66.9% to 75.0%, p < 0.01) and decreased perceived treatment barriers (2.1 to 1.9, p < 0.01); desire to quit all substances increased (7.2 to 7.8, p = 0.05). Self-reported opioid use was significantly decreased at each follow-up (all p < 0.01). Self-reported overdose-risk behaviors decreased significantly (6.2 to 2.4, p < 0.01). A majority of participants (65 %) reported naloxone utilization.

Conclusions: PTOEND may be effective for promoting harm reduction and treatment readiness.

Keywords: Harm reduction; Medication for opioid use disorder; Naloxone; Opioid; Overdose.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Analgesics, Opioid / pharmacology
  • Analgesics, Opioid / therapeutic use
  • Female
  • Follow-Up Studies
  • Harm Reduction / drug effects*
  • Harm Reduction / physiology
  • Humans
  • Male
  • Middle Aged
  • Naloxone / pharmacology
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / pharmacology
  • Narcotic Antagonists / therapeutic use*
  • Opiate Overdose / prevention & control*
  • Opiate Overdose / psychology
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / psychology
  • Patient Acceptance of Health Care / psychology
  • Patient Education as Topic / methods
  • Precision Medicine / methods*
  • Precision Medicine / psychology

Substances

  • Analgesics, Opioid
  • Narcotic Antagonists
  • Naloxone