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APHA Scientific Session and Event Listing

Tinka Markham Piper, MPH, CSW¹, Sasha Rudenstine¹, Susan Sherman, PhD², Vijay Nandi, MPH¹, Sharon Stancliff, MD³, and Sandro Galea, MD, DrPH⁴. (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, 212-822-7277, kmarkham@nyam.org, (2) Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6543, Baltimore, MD 21205, (3) Harm Reduction Coalition, 22 West 27th Street, 5th Floor, New York, NY 10001, (4) Department of Epidemiology, University of Michigan School of Public Health, 1214 South University, Room 243, Ann Arbor, MI 48104

Naloxone, an opiate antagonist that can avert opiate overdose morality, has long been prescribed to drug users in Europe and in a few US cities. However, there has been little documented evidence of naloxone distribution programs and their feasibility in the US. We conducted an evaluation (March-December 2006) of a comprehensive overdose prevention and naloxone administration training, developed as a collaboration between the Harm Reduction Coalition and NYC syringe exchange programs (SEPS). Drug users at SEPs were trained in naloxone administration and given naloxone. We conducted two cross-sectional surveys before and after drug users attended the training. The first survey assessed drug users' (N=389) prior overdose experience and responses to witnessed overdoses, including naloxone experience. The second survey was conducted among drug users returning for naloxone refills (N=122) and assessed their experience with naloxone use. In the first survey, 317 participants (81.7%) reported having witnessed an overdose during their lifetime; only 24 (7.7%) had administered naloxone. In the second survey, participants reported 82 uses of naloxone in overdoses and 68 overdose reversals (13 were unknown and 1 died). 97 of 118 participants (82.2%) said they felt comfortable or very comfortable using naloxone if indicated; 94 of 109 (86.2%) said they would want naloxone administered if overdosing. 31 of 115 (27.0%) reported having kept the naloxone with them at all times. Naloxone administration by injection drug users is feasible as part of a comprehensive overdose prevention strategy and may be a practicable way to reduce overdose deaths on a larger scale.

Learning Objectives:

• 1. Describe trends in drug overdose in NYC and the potential role of naloxone in reducing fatal opiate drug overdose
• 2. Discuss the overdose prevention and naloxone administration training at NYC SEPS as well as the two cross sectional surveys designed to evaluate overdose prevention efforts among participants.
• 3. Describe the results of both baseline and refill surveys, including the use of naloxone among participants as well as perceptions, knowledge and comfort with naloxone post-training.

Presenting author's disclosure statement:

Not Answered