RT Journal Article
SR Electronic
T1 Impacts of an opioid overdose prevention intervention delivered subsequent to acute care
JF Injury Prevention
JO Inj Prev
FD BMJ Publishing Group Ltd
SP injuryprev-2017-042676
DO 10.1136/injuryprev-2017-042676
A1 Caleb J Banta-Green
A1 Phillip O Coffin
A1 Joseph O Merrill
A1 Jeanne M Sears
A1 Chris Dunn
A1 Anthony S Floyd
A1 Lauren K Whiteside
A1 Norbert D Yanez
A1 Dennis M Donovan
YR 2018
UL http://injuryprevention.bmj.com/content/early/2018/02/07/injuryprev-2017-042676.abstract
AB Background Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons.Methods Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting for time at risk.Results During the follow-up period, 24% of the 241 participants had at least one overdose event, 85% had one or more ED visits and 55% had at least one hospitalisation, with no significant differences between intervention and comparison groups. The instantaneous risk of an overdose event was not significantly lower for the intervention group (sub-HR: 0.83; 95% CI 0.49 to 1.40).Discussion These null findings may be due in part to the severity of the population in terms of housing insecurity (70% impermanently housed), drug use, unemployment and acute healthcare issues. Given the high overdose and healthcare utilisation rates, more intensive interventions, such as direct referral and provision of housing and opioid agonist treatment medications, may be necessary to have a substantial impact on opioid overdoses for this high-acuity population in acute care settings.Trial registration number NCT0178830; Results.