Along with the increase of opioid-related deaths seen all over the country, visits to hospital emergency departments (ED) and inpatient admissions related to opioid use have increased dramatically over the years, reflecting the increase in non-fatal overdose cases.
Hospital ED and acute care settings are potentially important settings to reach people vulnerable to opioid overdose that may not access healthcare in other settings, such as substance use disorder treatment centers or primary care.
A NIDA-funded clinical trial led by ADAI Principal Research Scientist Caleb Banta-Green tested an overdose prevention intervention for opioid users seen in the Emergency Departments of Seattle's Harborview Medical Center and the University of Washington Medical Center. The intervention combined opioid overdose education, a take-home naloxone kit, and brief behavior change counseling. The research team wanted to test the impact of the intervention on participants’ subsequent opioid overdoses, ED visits, and hospitalizations.
The study found that the overdose prevention intervention had no statistically significant impact on subsequent overdoses, either positive or negative. This null finding is perhaps not surprising given the severity of medical and social problems of the population in terms of homelessness, drug use and other health and social issues. A brief, one-time intervention in acute care settings or subsequent to receiving acute care may not be sufficient to reduce serious overdose events. Study participants also had very high rates of subsequent emergency department visits and hospitalizations, and warrant more intensive interventions.
Citation: Banta-Green CJ, Coffin PO, Merrill JO, Sears JM, Dunn C, Floyd AS, Whiteside LK, Yanez ND, Donovan DM. Impacts of an opioid overdose prevention intervention delivered subsequent to acute care. Injury Prevention 2018 (in press).