The Virginia Department of Health (VDH) has distributed naloxone to partners since 2019. Initially, the program was demand-driven; it was up to partners to determine their need for naloxone and proactively reach out to the Naloxone Distribution Program. Beginning in 2023, VDH has taken a strategic, demand-driven approach to naloxone distribution, including identifying strategic partners and assessing distribution across the commonwealth. Key activities included:

• Publishing a detailed Naloxone Distribution and Saturation plan that identified barriers to naloxone access, key partners, and distribution strategies.
• Reviewing distribution data on a monthly basis and conducting strategic outreach as needed, e.g. to partner organizations like comprehensive harm reduction sites critical to naloxone access in Virginia.
• Developing a dashboard to visualize naloxone and harm reduction test strip data across Virginia, including providing access to this dashboard to local health district partners. This tool helps VDH visualize distribution of naloxone both geographically and by partner type.
• Establishing regional distribution targets to benchmark naloxone distribution and ensure equitable naloxone access across the Commonwealth.

In addition to these data-oriented activities, VDH also conducted outreach to key partners, including reaching out to potential new partners, encouraging partners to target distribution to high-risk individuals, and learning about partner challenges and opportunities. Key outcomes have included:

• Discussions with partners in each of VDH’s five regions to discuss challenges and opportunities of naloxone distribution in their communities.
• Increased participation of key, strategic partner types, e.g. establishing memorandums of understanding with all of Virginia’s community services boards (community-based mental health service providers).

This presentation will allow APHA attendees to learn from Virginia’s experiences, analyze naloxone distribution in their own states, and apply lessons learned to their own contexts, including in other states.

Issue:

In the United States, commercial fishing is a physically demanding job with high injury rates, long hours, productivity pressures, weak job security and challenges accessing health care. Commercial fishermen also face disproportionately high rates of health and behavioral health conditions, including an elevated risk of substance use disorders (SUDs), which is correlated with a high risk of substance related fatalities.

Description:

Fishing Partnership Support Services (FPSS) Community Health Workers provide education around substance use disorder as a disease and engage with fishermen to better understand their perceptions of opioid use. In New Bedford, Massachusetts, an FPSS Community Health Worker (CHW) spent years developing messaging focused on fishermen being first responders at sea. When an overdose occurs onboard a vessel, fishermen are often closer and able to respond more quickly than the United States Coast Guard.

Lessons Learned:

FPSS’ CHW model was key to better understanding perceptions about substance use disorder and providing fishing industry workers with Opioid Overdose Education and Naloxone Distribution (OEND) training. By recognizing that fishermen are first responders at sea, FPSS has reframed the purpose of the training and overcome traditional barriers surrounding substance use disorder.

Reccomendations:

FPSS uses a community-based model to deliver our customized OEND training to members of the fishing industry. Employing a model that celebrates and recognizes the diversity present in fishing communities serves to enhance the accessibility of our CHW teams, ultimately furthering the effectiveness of our outreach and training efforts. FPSS will share information about how our staff has overcome stigmas and stereotypes and provided OEND training to over 2,000 fishermen on the East Coast of the United States.

Issue: In Chicago, the number of fatal overdoses due to opioids reached a historic high in 2020 and continued rising in 2021, over which 1,441 people died of an opioid-related overdose. Amid this crisis, the Chicago Department of Public Health (CDPH) leveraged other city agencies and community-based organizations to serve as low-barrier purveyors of naloxone and harm reduction.

Description: In Fall of 2021, CDPH engaged Chicago Public Library (CPL) to make naloxone nasal sprays (Narcan) freely and anonymously available at all 81 branches and to provide harm reduction training to CPL staff. By January 2022, all CPL branches have installed Narcan dispenser boxes near entrances and over 700 staff members have received harm reduction training. Simultaneously, CDPH engaged with local leaders and elected officials, including aldermen, faith-based leaders, the Chicago Independent Venue Leagues (CIVL), shelters ran by the Department of Family and Support Services (DFSS) among others for a similar program. By March 2024, over 44,000 Narcan kits have been distributed through these organizations (average of 0.7 per 100 population from 2022-2023), of which 44% were distributed through CPL. From 2021 to 2022, the number of overdose deaths due to opioids in Chicago decreased from 1,441 to 1,397.

Lessons Learned: Making naloxone readily available in communities impacted by opioid overdose is a critical piece of harm reduction. In Illinois, a state which provides community-based organizations and government agencies with naloxone through the Drug Overdose Prevention Program, local health departments can serve as a major conduit for naloxone distribution and harm reduction education.

Recommendations: Local health departments should leverage partnerships with community-based organizations and other government agencies to scale low-barrier access to Narcan and substance-use related harm reduction.

Introduction:

Overdoses are the leading cause of death for ages 18-45 in the US. In 2022, fentanyl, which is often laced in substances without the users knowing, caused approximately two-thirds of all drug-related deaths. Experimental drug use puts college students more at risk for overdose. End Overdose (EO) has designed a robust peer-to-peer overdose prevention and response (OdPR) training program to combat the ongoing opioid epidemic across college campuses in the US.

Methods:

Participants completed a four-question survey (via QR code on their mobile devices) about overdose prevention before and after participation in peer-to-peer training. Survey responses were collected from November 2023 to March 2024. A paired samples t-test was employed to assess training efficacy and participant acumen pre- and post-training.

Results:

Participants (N=1,563) were 60% White, 22% Hispanic/Latino, 5% black/African American, 19% Asian, <2% American Indian/Alaskan Native, <1% Other. Most of the participants were female, 61%, and between 16-24 years old, 78%. Among participants who completed the training, the pre-survey mean was 4.21 out of 7 (60.1%, SD=1.75; N=1563), while the average quiz score post-training increased to 5.2 (74.3%, SD=1.85); a statistically significant increase among survey participant (p-value<0.0001).

Conclusion:

EO’s implementation model facilitates community collaborations to coordinate OdPR trainings and naloxone distribution for populations at risk for opioid overdose. With various risk factors and the prevalence of substance use among college students, universities present an ideal setting to require substance use safety education and resources to be made accessible for college students nationwide.

Background: Opioid overdose remains a leading cause of death in Utah, indicating a need to target overdose prevention trainings for high-risk groups. This includes service industry employees (SIE) who work at bars, restaurants, etc., due to their interaction with high-risk groups and higher rates of personal substance use. To address this issue, Utah State University Extension faculty developed and implemented an overdose prevention training tailored for SIE modeled after promising pilot studies in other states.

Methods: We developed and delivered a 40-minute on-site training to improve knowledge, skills, and efficacy of SIE to respond to opioid overdoses. The training included key information on signs of opioid overdose, how to administer Narcan® (the nasal spray version of Naloxone), legal considerations, and self-care. Participants completed pre- and post-surveys using modified versions of the Opioid Overdose Attitudes Scale (OOAS) and the Opioid Overdose Knowledge Scale (OOKS). Pre-and-post survey results were compared using t-test for continuous variables (OOAS), and chi-square test for proportions (OOKS).

Results: To date, we have trained 90 service industry employees at six organizations of which 56 completed the pre-Survey, 47 completed the post-survey, and 7 completed the 6-week follow up survey. Most participants identified as White (85.7%), non-Hispanic (17.9%) and female (55.4%). Among participants, 35% reported having family or friends at risk of overdose. The overall scores on the 7-item OOAS significantly increased from a mean of 23.79 pre-survey to 31.86 post-survey (p<.001, t=5.57), indicating an increase in skills and abilities to respond to an opioid overdose. The change in score of correct answers on the 10-item OOKS from pre-and-post survey increased from 62.0% to 84%% (p<.001) indicating improvement in overall knowledge of opioid overdose.

Conclusions: This training improved attitudes, knowledge, and self-efficacy among SIE to respond to opioid overdose using Narcan(r), increasing the ability to reduce overdose deaths.