Evaluation of a personally-tailored opioid overdose prevention education and naloxone distribution intervention to promote harm reduction and treatment readiness in individuals actively using illicit opioids. (1st November 2020)

• Record Type: Journal Article
• Authors: Winhusen, Theresa; Wilder, Christine; Lyons, Michael S.; Theobald, Jeff; Kropp, Frankie; Lewis, Daniel
• Is Part Of: Drug and alcohol dependence. Volume 216(2020)
• Publication Date: 2020-11-01
• Subjects: Opioid -- Overdose -- Naloxone -- Harm reduction -- Medication for opioid use disorder; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.108265
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: We developed a personally-tailored opioid overdose education intervention (PTOEND). Our secondary analysis of clinical trial data assessed outcomes pre- and post-PTOEND. Week 3: Perceived treatment barriers decreased; overdose and MOUD knowledge improved. Month 12: Self-reported opioid use and overdose-risk behaviors decreased. PTOEND may be effective for promoting harm reduction and treatment readiness. Abstract: Background: Opioid overdose prevention education and naloxone distribution (OEND) programs include information on general risk factors, overdose recognition, and naloxone utilization. This study evaluated a personally-tailored OEND (PTOEND) intervention designed to promote harm reduction and treatment readiness for illicit opioid users by also including education about personal overdose-risk factors and medication for opioid use disorder (MOUD). Method: A secondary analysis of a randomized controlled trial testing a Peer recovery support service (PRSS) intervention, relative to Control, in adult illicit opioid users reporting treatment for an overdose in the prior 6 months. PTOEND, a 30-minute computer-guided intervention, was administered by a research assistant at the randomization visit to all participants (N = 80). Participants completed a telephone visit 3 weeks post-randomization (n = 74) to assess changes in opioid overdose/MOUD knowledge and treatment readiness. Participants completed in-person visits at 3 (n = 66), 6 (n = 58), and 12 (n = 44) months post-randomization to assess illicit opioid use and naloxone utilization (all time points) and overdose-risk behaviors (12 months). We conducted pre-post analyses of the impact of PTOEND controlling for the PRSS effect. Results: PTOEND increased knowledge of overdose (79.8% to 81.5%, p < 0.05) and MOUD (66.9% to 75.0%, p < 0.01) and decreased perceived treatment barriers (2.1 to 1.9, p < 0.01); desire to quit all substances increased (7.2 to 7.8, p = 0.05). Self-reported opioid use was significantly decreased at each follow-up (all p < 0.01). Self-reported overdose-risk behaviors decreased significantly (6.2 to 2.4, p < 0.01). A majority of participants (65 %) reported naloxone utilization. Conclusions: PTOEND may be effective for promoting harm reduction and treatment readiness.