217284 Assessing the implementation of opioid overdose education and naloxone distribution in Massachusetts: The Intranasal Naloxone and Prevention EDucation's Effect on OverDose (INPEDE OD) Study

Monday, November 8, 2010 : 11:06 AM - 11:24 AM

Alexander Walley, MD, MSc , Section of General Internal Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA
Courtney Pierce, MPH , Section of General Internal Medicine, Boston Medical Center, Boston, MA
Al Ozonoff, PhD , Biostatistics, Boston University School of Public Health, Boston, MA
Holly Hackman, MD, MPH , Injury Prevention and Control Program, Massachusetts Department of Public Health, Boston, MA
Sarah Ruiz, MSW , Bureau of Substance Abuse Services, Massachusetts Department of Public Health, Boston, MA
Barry Callis, MSW , Office of HIV/AIDS, Massachusetts Department of Public Health, Boston, MA
Daniel Hovelson , Data Coordinating Center, Boston University School of Public Health, Boston, MA
Andy Epstein, RN, MPH , Special Assistant to the Commissioner, Massachusetts Department of Public Health, Boston, MA
Background: In Massachusetts from 1990 to 2006, growth in opioid prescriptions, nonmedical use of opioids, and heroin availability drove a six-fold increase (94 to 637) in annual opioid-related fatal overdoses. In 2006, the Massachusetts Department of Public Health implemented overdose education and intranasal naloxone distribution (OEND) in 8 established community-based organizations. These organizations train potential bystanders on how to reduce overdose risk, recognize signs of overdose, access emergency medical services, and administer intranasal naloxone. Methods: To assess implementation, we used data collected from each enrollee and reported overdose reversal. Forms provided demographics, zip codes of residence and overdose, overdose history, overdose circumstances, substance use, and medical care utilization. To determine impact we will measure changes in fatal and non-fatal overdose rates from 2002 through 2009 in the 18 Massachusetts communities with highest numbers of opioid overdoses. The primary comparisons will be between communities where OEND programs were implemented and communities where they were not, using an interrupted time series analysis. Results: From 2006 through 2009, more than 4000 potential bystanders have been trained and over 500 opioid overdose reversals documented. Two thirds of the trainees were active drug users. Active users had high rates of polysubstance use, previous overdose, and witnessing overdose. Almost half of non-users (friends, families, professionals) had witnessed a previous overdose. Significance: Massachusetts OEND programs have reached high-risk active users and non-users who have witnessed previous overdose. The INPEDE OD Study will determine the impact of OEND programs on fatal and non-fatal opioid overdose rates in Massachusetts.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related research

Learning Objectives:
1. Assess the implementation of a statewide community-based overdose education and naloxone distribution (OEND) program. 2. Describe the planned methodology for determining the impact of the OEND program on fatal and non-fatal overdose rates.

Keywords: Substance Abuse, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the program manager of this study and oversee another substance abuse treatment program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.