Journal of Community Health

, Volume 38, Issue 1, pp 133–141 | Cite as

Injection Drug Users Trained by Overdose Prevention Programs: Responses to Witnessed Overdoses

  • Stephen E. Lankenau
  • Karla D. Wagner
  • Karol Silva
  • Aleksandar Kecojevic
  • Ellen Iverson
  • Miles McNeely
  • Alex H. Kral
Original Paper


In response to the growing public health problem of drug overdose, community-based organizations have initiated overdose prevention programs (OPPs), which distribute naloxone, an opioid antagonist, and teach overdose response techniques. Injection drug users (IDUs) have been targeted for this intervention due to their high risk for drug overdose. Limited research attention has focused on factors that may inhibit or prevent IDUs who have been trained by OPPs to undertake recommended response techniques when responding to a drug overdose. IDUs (n = 30) trained by two OPPs in Los Angeles were interviewed in 2010–2011 about responses to their most recently witnessed drug overdose using an instrument containing both open and closed-ended questions. Among the 30 witnessed overdose events, the victim recovered in 29 cases while the outcome was unknown in one case. Participants responded to overdoses using a variety of techniques taught by OPPs. Injecting the victim with naloxone was the most commonly recommended response while other recommended responses included stimulating the victim with knuckles, calling 911, and giving rescue breathing. Barriers preventing participants from employing recommended response techniques in certain circumstances included prior successes using folk remedies to revive a victim, concerns over attracting police to the scene, and issues surrounding access to or use of naloxone. Practical solutions, such as developing booster sessions to augment OPPs, are encouraged to increase the likelihood that trained participants respond to a drug overdose with the full range of recommended techniques.


Community-based organizations Overdose prevention Naloxone Injection drug user 



This research was supported by NIH grants: K01DA031031, R21DA026789, and T32DA023356. The authors would like to thank the leadership and staff of the two community-based organizations that participated in this study: Mark Casanova (HHCLA), James Hundley (HHCLA), Angelica Skouras (HHCLA), Sharon Chamberlain (CGW), Daniel Getzoff (CGW), and Michael ‘Dray’ Papiz (CGW), as well as the respondents that provided data for the project.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Stephen E. Lankenau
    • 1
  • Karla D. Wagner
    • 3
  • Karol Silva
    • 1
  • Aleksandar Kecojevic
    • 1
  • Ellen Iverson
    • 2
  • Miles McNeely
    • 2
  • Alex H. Kral
    • 4
  1. 1.Department of Community Health and Prevention, School of Public HealthDrexel UniversityPhiladelphiaUSA
  2. 2.Division of Adolescent MedicineChildrens Hospital Los AngelesLos AngelesUSA
  3. 3.Division of Global Public Health, Department of MedicineUniversity of California, San DiegoLa JollaUSA
  4. 4.RTI InternationalSan FranciscoUSA

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