Evaluation of an Opiate Overdose Educational Intervention and Naloxone Prescribing Program in Homeless Adults Who Use Opiates

Abstract Opiate overdose deaths are considered an epidemic by the Centers for Disease Control and Prevention. Homeless adults are disproportionately affected by opioid overdoses. The purpose of this project was to implement an opiate overdose training and routine naloxone prescribing program for patients at a Health Care for the Homeless clinic. Education consisted of overdose risk factors, signs of overdose, how to respond to an opiate overdose, and how to administer naloxone. Knowledge was measured with a pretest and a posttest. Intranasal naloxone was prescribed for each person who received the education, and prescription fill rates were tracked 1 week after the clinic visit. Patients had a significant increase in knowledge, and the overall naloxone fill rate was 33%. Fill rates varied by housing, insurance, and other prescription status. Opiate overdose education can effectively be delivered in a homeless medical clinic, although more research is needed regarding barriers to naloxone fill rates.

[1]  Naloxone , 2021, Reactions Weekly.

[2]  Jeffrey P. Bratberg,et al.  Prescribe to Prevent: Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists , 2016, Journal of addiction medicine.

[3]  Jason M Glanz,et al.  A Review of Opioid Overdose Prevention and Naloxone Prescribing: Implications for Translating Community Programming into Clinical Practice , 2015, Substance abuse.

[4]  P. Coffin,et al.  Brief overdose education is sufficient for naloxone distribution to opioid users. , 2015, Drug and alcohol dependence.

[5]  C. Wilder,et al.  A Systematic Review of Community Opioid Overdose Prevention and Naloxone Distribution Programs , 2014, Journal of addiction medicine.

[6]  E. Begier,et al.  Programmatic impact of 5 years of mortality surveillance of New York City homeless populations. , 2013, American journal of public health.

[7]  E John Orav,et al.  Mortality among homeless adults in Boston: shifts in causes of death over a 15-year period. , 2013, JAMA internal medicine.

[8]  Al Ozonoff,et al.  Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis , 2013, BMJ.

[9]  Alex H. Kral,et al.  Characteristics of an Overdose Prevention, Response, and Naloxone Distribution Program in Pittsburgh and Allegheny County, Pennsylvania , 2011, Journal of Urban Health.

[10]  T. Valente,et al.  Evaluation of an overdose prevention and response training programme for injection drug users in the Skid Row area of Los Angeles, CA. , 2010, The International journal on drug policy.

[11]  R. Christensen Adapting Your Practice: General Recommendations for the Care of Homeless Patients (review) , 2004 .