Injection Drug Users Trained by Overdose Prevention Programs: Responses to Witnessed Overdoses
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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.
KeywordsCommunity-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.
- 5.Centers for Disease Control and Prevention. (2012). MMWR weekly. Community-based opioid overdose prevention programs providing naloxone—United States, 2010. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6106a1.htm.
- 8.Seal, K. H., Thawley, R., Gee, L., Bamberger, J., Kral, A. H., Ciccarone, D., et al. (2005). Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: A pilot intervention study. Journal of Urban Health, 82(2), 303–311.PubMedCrossRefGoogle Scholar
- 9.Martin, W. R. (1967). Opioid antagonists. Pharmacological Reviews, 19(4), 464–521.Google Scholar
- 10.Julien, R. M. (2005). A primer on drug action. New York: Worth.Google Scholar
- 16.Wagner, K. D., Valente, T. W., Casanova, M., Partovi, S. M., Mendenhall, B. M., Hundley, J. H., et al. (2010). Evaluation of an overdose prevention and response training programme for injection drug users in the Skid Row area of Los Angeles, CA. International Journal of Drug Policy, 21(3), 186–193.PubMedCrossRefGoogle Scholar
- 22.BantaGreen, C. J., Kuszler, P. C., Coffin, P. O., & Schoeppe, J. A. Washington’s 911 Good Samaritan Drug Overdose Law–Initial Evaluation Results. Alcohol & Drug Abuse Institute, University of Washington, November 2011. Retrieved from http://adai.uw.edu/pubs/infobriefs/ADAI-IB-2011-05.pdf.
- 23.New Mexico Department of Health. (2007). Department of health encourages people to seek medical help for overdose—NM first state in nation to pass 911 good samaritan law. Retrieved from http://www.health.state.nm.us/pdf/harmreduction.pdf.
- 24.Harm Reduction Coalition (2012). Mouth-to-mouth resuscitation is essential in responding to opioid overdoses. Retrieved from http://harmreduction.org/issue-area/overdose-prevention-issue-area/hands-only-cpr-statement/.