Overdose Management Training and Take-home Naloxone for Opiate-Using Persons May Save Lives

Opiate overdose is the cause of most drug-related mortality, and witnesses are commonly present. An initiative to provide training in the management of overdose was delivered to staff in 20 drug treatment facilities across England during 2005/2006. These staff then provided 239 opiate-using addiction treatment patients with training in management of overdose and a take-home supply of naloxone. The patients completed surveys before, immediately after, and 3 months after the training. At baseline, more than 90% of patients could recognize some signs of opioid overdose.

Among the 186 patients (78%) who completed 3-month follow-up:

• 90% reported still using illicit opiates.
• Over 96% recalled the correct intramuscular injection sites for the naloxone, 77% retained knowledge of the recovery breathing position, and almost 98% remained confident in their ability to recognize and manage an overdose.
• Close to 80% retained their naloxone, and 28% had trained a friend or family member to administer it should the participant overdose.
• 18 reported witnessing or experiencing an overdose during the 3-month period. Patients used their naloxone to revive other people on 10 occasions, and 2 received naloxone from ambulance staff.
• 1 death resulted among the 6 overdoses where naloxone was not administered.
• No adverse reactions were reported.

Comments by Michael Levy, PhD
Despite a short follow-up period, this study suggests that patients in addiction treatment can be taught to recognize and treat opiate overdose with intramuscular naloxone. Many of the patients also taught friends and family how to administer naloxone. Providing such training may prevent fatal opiate overdose and, as such, should be considered both for addicts as well as for their friends and family members.