Education and response programs reduce opioid overdose deaths

By Mark Cowen, senior medwireNews Reporter

Results from a US study suggest that a state-supported program of overdose education and nasal naloxone distribution (OEND) for potential bystanders can help reduce opioid-related overdose deaths.

In a study of 19 Massachusetts communities, Alexander Walley (Boston Medical Center, Massachusetts) and team found that death rates due to opioid overdose were lower in communities that implemented the OEND training program than in those that did not.

Furthermore, greater reductions in death rates were observed in communities with a higher proportion of trained individuals.

"Opioid overdose is a major public health problem for which we have few proven solutions," said Walley in a press statement. "This study provides observational evidence that OEND can have a population-level dose effect in reducing overdose death rates, where the greater the implementation, the greater the impact."

The OEND program consists of training potential bystanders, such as the family and friends of opioid users, and social service agency staff, in how to recognize, prevent, and respond to an overdose by seeking emergency medical services help, conducting rescue breathing, and delivering naloxone, an effective antidote that reduces the life-threatening effects of an opioid overdose.

Between 2006 and 2009, a total of 2912 individuals from the participating communities, which all had a high prevalences of opioid overdose deaths, were enrolled in the OEND program, and 327 rescue attempts were made.

After accounting for community-level factors, such as mean age, methadone treatment services, poverty, and prescriptions to "doctor shoppers," the researchers found that, by 2009, opioid overdose death rates were significantly lower in communities with high levels of OEND training (>100 enrolments per 100,000 population) than in those with no training, at an adjusted rate ratio (RR) of 0.54.

Opioid overdose death rates were also significantly reduced in communities with low levels of OEND training (1-100 enrollments per 100,000 population) compared with those with no training, at an adjusted RR of 0.73.

Walley et al conclude in the BMJ: "This study provides strong support for the public health agency policy and community based organisation practice to implement and expand OEND programs as a key way to address the opioid overdose epidemic."

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