246744 Comparing Overdose Response Behaviors Between Trained and Untrained Injection Drug Users: The Impact of Overdose Prevention Programs

Monday, October 31, 2011

Stephen E. Lankenau, PhD , Community Health and Prevention, Drexel University, School of Public Health, Philadelphia, PA
Karla D. Wagner, PhD , Division of Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA
Miles McNeeley, MSW , Community, Health Outcomes, and Intervention Research Program, Childrens Hospital Los Angeles, Los Angeles, CA
Jennifer Jackson Bloom, MPH , Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Karol Silva, MPH , School of Public Health, Drexel University, Philadelphia, PA
Aleksandar Kecojevic, MPH , Department of Community Health, Drexel School of Public Health, Philadelphia, PA
Ellen Iverson, MPH , Division of Adolescent Medicine, Children's Hospital Los Angeles, Los Angeles, CA
Introduction: Overdose prevention training programs (ODPT) for injection drug users (IDUs) have the potential to reduce incidence of fatal overdose, a leading cause of mortality in this population. Programs teach IDUs how to recognize and respond to overdose, and many include training in administering naloxone (an opioid antagonist) to overdose victims. Though agencies usually offer training to all clients, not all clients participate. A study was devised to determine how response to drug overdose varied between trained and untrained IDUs.

Methods: Trained (n=29) and untrained (n=77) IDUs who recently witnessed an overdose were recruited from two Los Angeles needle exchanges that provide ODPT (2010-11). During semi-structured interviews, participants described how they responded to a recently witnessed overdose. Qualitative and quantitative data were compared.

Findings: Several differences were observed. Trained participants were more typically: female; heroin injectors; and had overdosed themselves in the past 12 months. Regarding the most recently witnessed overdose, trained participants were more adept at recognizing overdose symptoms, more commonly performed recommended response techniques, such as rescue breathing and administering naloxone, and less commonly “did nothing.” Most significantly, none of the trained respondents reported that the overdose victim died compared to 14% of untrained participants. In contrast, both “called 911” in response to the overdose about 25% of the time.

Conclusions: Findings highlight the need to better understand factors that inhibit some IDUs from accessing training in order to increase program uptake. Additionally, efforts are needed to reduce barriers to calling 911 in the event of an overdose.

Learning Areas:
Administer health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe differences in response between ODPT trained and untrained IDU. 2. Identify factors that prevent some IDUs from accessing training. 3. Discuss implications for developing future ODPTs targeting IDUs.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified because I am the PI of the study.
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.