References

Albert S, Brason FW, Sanford CK, Dasgupta N, Graham J, Lovette B. Project Lazarus: community-based overdose prevention in rural North Carolina. Pain Med. 2011; 12:S77-S85 https://doi.org/10.1111/j.1526-4637.2011.01128.x

Bachyrycz A, Takeda MY, Wittstrom K, Bleske B. Opioid overdose response training in pharmacy education: an analysis of students' perception of naloxone use for opioid overdose prevention. Curr Pharm Teach Learn. 2019; 11:(2)166-171 https://doi.org/10.1016/j.cptl.2018.11.007

Carter G, Caudill P. Integrating naloxone education into an undergraduate nursing course: Developing partnerships with a local department of health. Public Health Nurs. 2020; 37:(3)439-445 https://doi.org/10.1111/phn.12707

Clark AK, Wilder CM, Winstanley EL. A systematic review of community opioid overdose prevention and naloxone distribution programs. J Addict Med. 2014; 8:(3)153-163 https://doi.org/10.1097/ADM.0000000000000034

Crocker A, Bloodworth L, Ballou J, Liles AM, Fleming L. First responder knowledge, perception and confidence in administering naloxone: impact of a pharmacist-provided educational program in rural Mississippi. J Am Pharm Assoc. 2003; 59:(4S)S117-S121.e2 https://doi.org/10.1016/j.japh.2019.04.011

Dahlem CHG, King L, Anderson G, Marr A, Waddell JE, Scalera M. Beyond rescue: implementation and evaluation of revised naloxone training for law enforcement officers. Public Health Nurs. 2017; 34:(6)516-521 https://doi.org/10.1111/phn.12365

Erie County Opiate Epidemic Task Force. Erie County Opiate Epidemic Task Force quarterly meeting. 2020. https//tinyurl.com/jzn2ksm5 (accessed 20 July 2021)

Eukel HN, Skoy E, Werremeyer A, Burck S, Strand M. Changes in pharmacists' perceptions after a training in opioid misuse and accidental overdose prevention. J Contin Educ Health Prof. 2019; 39:(1)7-12 https://doi.org/10.1097/CEH.0000000000000233

Galea S, Worthington N, Piper TM, Nandi VV, Curtis M, Rosenthal DM. Provision of naloxone to injection drug users as an overdose prevention strategy: early evidence from a pilot study in New York City. Addict Behav. 2006; 31:(5)907-912 https://doi.org/10.1016/j.addbeh.2005.07.020

Green BL, Mirana J, Daroowalla A, Siddique J. Trauma exposure, mental health functioning, and program needs of women in jail. Crime and Delinquency. 2005; 51:(1)133-151 https://doi.org/10.1177/0011128704267477

Guy GP, Zhang K, Bohm MK Vital signs: changes in opioid prescribing in the united states, 2006–2015. MMWR Morb Mortal Wkly Rep. 2017; 66:(26)697-704 https://doi.org/10.15585/mmwr.mm6626a4

Hedegaard H, Miniño AM, Warner M. Drug overdose deaths in the United States, 1999–2018. NCHS Data Brief. 2020; 356:1-8

Jawa R, Luu T, Bachman M, Demers L. Rapid naloxone administration workshop for health care providers at an academic medical center. MedEdPORTAL. 2020; 16 https://doi.org/10.15766/mep_2374-8265.10892

Kim HK, Nelson LS. Reducing the harm of opioid overdose with the safe use of naloxone: a pharmacologic review. Expert Opin Drug Saf. 2015; 14:(7)1137-1146 https://doi.org/10.1517/14740338.2015.1037274

Kwon M, Moody AE, Thigpen J, Gauld A. Implementation of an opioid overdose and naloxone distribution training in a pharmacist laboratory course. Am J Pharm Educ. 2020; 84:(2) https://doi.org/10.5688/ajpe7179

Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP. 1989. A modified labeling theory approach to mental disorders: an empirical assessment. American Sociological Review. 1989; 54:(3)400-423 https://doi.org/10.2307/2095613

Lowenstein M, Feuerstein-Simon R, Dupuis R Overdose awareness and reversal trainings at Philadelphia public libraries. Am J Health Promot. 2021; 35:(2)250-254 https://doi.org/10.1177/0890117120937909

Meier AC, Csiernik R, Warner L, Forchuk C. The stigma scale: a Canadian perspective. Social Work Research. 2015; 39:(4)1-10 https://doi.org/10.1093/swr/svv028

Mueller SR, Walley AY, Calcaterra SL, Glanz JM, Binswanger IA. A review of opioid overdose prevention and naloxone prescribing: implications for translating community programming into clinical practice. Subst Abus. 2015; 36:(2)240-253 https://doi.org/10.1080/08897077.2015.1010032

National Institute on Drug Abuse. Opioid overdose crisis. 2021. https//www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis (accessed 20 July 2021)

O'Donnell J, Gladden RM, Goldberger BA, Mattson CL, Kariisa M. Notes from the field: opioid-involved overdose deaths with fentanyl or fentanyl analogs detected—28 states and the District of Columbia, July 2016-December 2018. MMWR Morb Mortal Wkly Rep. 2020; 69:(10)271-273 https://doi.org/10.15585/mmwr.mm6910a4

Oliva EM, Nevedal A, Lewis ET, McCaa MD, Cochran MF, Konicki PE, Davis CS, Wilder C. Patient perspectives on an opioid overdose education and naloxone distribution program in the US Department of Veterans Affairs. Subst Abus. 2016; 37:(1)118-126 https://doi.org/10.1080/08897077.2015.1129528

Purviance D, Ray B, Tracy A, Southard E. Law enforcement attitudes towards naloxone following opioid overdose training. Subst Abus. 2017; 38:(2)177-182 https://doi.org/10.1080/08897077.2016.1219439

Schartel A, Lardieri A, Mattingly A, Feemster AA. Implementation and assessment of a naloxone-training program for first-year student pharmacists. Curr Pharm Teach Learn. 2018; 10:(6)717-722 https://doi.org/10.1016/j.cptl.2018.03.016

Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G. Drug and opioid-involved overdose deaths—United States, 2013–2017. MMWR Morb Mortal Wkly Rep. 2018; 67:(5152)1419-1427 https://doi.org/10.15585/mmwr.mm675152e1

Skoy E, Eukel H, Frenzel J, Werremeyer A. Preparing student pharmacists to identify opioid misuse, prevent overdose and prescribe naloxone. Curr Pharm Teach Learn. 2019; 11:(5)522-527 https://doi.org/10.1016/j.cptl.2019.02.013

Taylor LK, Goldberg MG, Tran MD. Promoting student success: how do we best support child and youth survivors of catastrophic events?. Curr Psychiatry Rep. 2019; 21:(9) https://doi.org/10.1007/s11920-019-1067-3

Wagner KD, Davidson PJ, Iverson E ‘I felt like a superhero’: the experience of responding to drug overdose among individuals trained in overdose prevention. Int J Drug Policy. 2014; 25:(1)157-165 https://doi.org/10.1016/j.drugpo.2013.07.003

Wagner KD, Bovet LJ, Haynes B, Joshua A, Davidson PJ. Training law enforcement to respond to opioid overdose with naloxone: impact on knowledge, attitudes, and interactions with community members. Drug Alcohol Depend. 2016; 165:22-28 https://doi.org/10.1016/j.drugalcdep.2016.05.008

Wahl OF, Susin J, Kaplan L, Lax A, Zatina D. Changing knowledge and attitudes with a middle school mental health education curriculum. Stigma Res Action. 2011; 1:(1)44-53 https://doi.org/10.5463/sra.v1i1.17

Walley AY, Xuan Z, Hackman HH, Quinn E, Doe-Simkins M, Sorensen-Alawad A, Ruiz S, Ozonoff A. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013; 346 https://doi.org/10.1136/bmj.f174

Wheeler E, Jones TS, Gilbert MK, Davidson PJ Opioid overdose prevention programs providing naloxone to laypersons—United States, 2014. MMWR Morb Mortal Wkly Rep. 2015; 64:(23)631-635

World Health Organization. Opioid overdose. 2020. https//www.who.int/news-room/fact-sheets/detail/opioid-overdose (accessed 20 July 2021)

Williams AV, Strang J, Marsden J. Development of opioid overdose knowledge (OOKS) and attitudes (OOAS) scales for take-home naloxone training evaluation. Drug Alcohol Depend. 2013; 132:(1–2)383-866 https://doi.org/10.1016/j.drugalcdep.2013.02.007

Wilson N, Kariisa M, Seth P, Smith H, Davis NL. Drug and opioid-involved overdose deaths—United States, 2017–2018. MMWR Morb Mortal Wkly Rep. 2020; 69:(11)290-297 https://doi.org/10.15585/mmwr.mm6911a4

Wolfson-Stofko B, Gwadz MV, Elliott L, Bennett AS, Curtis R. ‘Feeling confident and equipped’: evaluating the acceptability and efficacy of an overdose response and naloxone administration intervention to service industry employees in New York City. Drug Alcohol Depend. 2018; 362-370 https://doi.org/10.1016/j.drugalcdep.2018.08.001

Zhang X, Marchand C, Sullivan B, Klass EM, Wagner KD. Naloxone access for emergency medical technicians: an evaluation of a training program in rural communities. Addict Behav. 2018; 86:79-85 https://doi.org/10.1016/j.addbeh.2018.03.004

leadership and managment

Training to improve responder attitudes and knowledge of opioid overdose

02 August 2021
Features
02 August 2021
Volume 13 · Issue 8

Abstract

Background:

Opioid use is a major public health issue and opioid overdose requires rapid response with naloxone.

Aims:

This study assesses the impact of a training session on the knowledge and attitudes of first responders and members of the community regarding opioid overdose recognition and naloxone use.

Methods:

A training session was delivered to 2327 participants between July 2019 and March 2020. The study used a paired, pre-/post-analysis to quantify changes.

Findings:

Nearly all (99.7%) participants completed a survey before and after training. Statistically significant improvements were observed in nearly all attitude and knowledge items.

Conclusion:

An education session delivered to an educationally and professionally diverse group can improve trainees' knowledge and attitudes. There were some significant differences between sub-groups, particularly regarding their professional and educational background, and whether the location was urban or rural. Further study is needed to examine whether trainees would benefit from a course tailored toward their education and professional experience.

After completing this module, the paramedic will be able to:

The misuse of opioids is a worldwide crisis that affects public health and welfare (National Institute on Drug Abuse, 2021; World Health Organization (WHO), 2021). Opioid overdose requires rapid response with naloxone (Kim and Nelson, 2015). In 2017, opioid overdose deaths accounted for approximately two-thirds of all drug overdose deaths in the United States (Scholl et al, 2018; Wilson et al, 2020). Worldwide, about half a million deaths are attributable to drug use, of which more than 70% are related to opioids, with over 30% of those deaths caused by overdose (WHO, 2020).

In recent years, opioid overdose deaths have been driven primarily by synthetic opioids such as fentanyl (Scholl et al, 2018; Wilson et al, 2020). In 2017–2018, deaths involving all opioids, prescription opioids and heroin decreased by 2%, 14% and 4% respectively. However, deaths involving synthetic opioids increased by 10%, likely driven by illicitly manufactured fentanyl, including fentanyl analogues (Guy et al, 2017; Scholl et al, 2018; Hedegaard et al, 2020; O'Donnell et al, 2020; Wilson et al, 2020).

Subscribe to get full access to the Journal of Paramedic Practice

Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed

Register
Or continue by

Signing in with your registered email address