Startup challenges to implementing a naloxone distribution program

BACKGROUND: Opiate overdose is the leading cause of mortality among opioid users and is preventable. Evidence suggests that pharmacological interventions like prescription naloxone may successfully prevent fatal opiate overdose, numerous such programs are currently operational. METHODS: The training occurs at a storefront located in a high drug trafficking area and, recently, in four community agencies. Participants are recruited from the community through targeted outreach, including with the mobile needle exchange. Participants attend a one-hour overdose prevention training addressing avoidance of high-risk situations, how to identify an overdose, and bystander response including the use of naloxone, which is distributed at the training. The program receives broad support from community organizations and numerous consumers have reported word of mouth “advertising” of the program. RESULTS: The curriculum has been presented to more than 20 community service agencies. Training occurs in five locations. Nonetheless, between July 2005 and February 2006 15 participants have completed the training. CONCLUSIONS: A success of the program is increasing overdose prevention awareness among service providers. The key challenge is providing naloxone to the people who need it. Consumer feed back suggests: focusing efforts solely in fixed sites limits accessibility and length of training is a deterrent. No service program receives heavy IDU foot traffic. The needle exchange's most successful efforts are the mobile exchange. If a shorter, mobile, version of the training were initiated it would increase accessibility to the targeted population. We are currently working with the health department and Institutional Review Board to realize these changes.