Background : We are amidst of a large-scale opioid epidemic that impacts our patients and communities with no sense of discrimination or short-term relief. An average of 197 Americans died of an opioid overdose per day in 2017. However, there is an antidote, naloxone. Most overdoses are witnessed, providing an opportunity to reduce fatalities. Registered as an Opioid Overdose Prevention Program (OOPP), our Emergency Departments (EDs) developed team-based protocols for overdose prevention education and rescue kit dispensing.
Objective : Capitalizing on our robust Screening, Brief Intervention, and Referral to Treatment (SBIRT) program, we developed and operationalized an additional layer, the Naloxone Saturation Campaign (NAL-SAT). Establishing a team of Certified Naloxone Educators, we offered education on opioid overdose prevention, recognition, response, and naloxone rescue to patients, respective friends and families, and ED staff. Diversifying the clinical portfolio of multiple ED settings facilitated the process empowering a community of first responders for this crisis.
Methods : SBIRT Health Coaches (HCs) completed a brief 5-item screening for opioid overdose risk factors with every patient they met with in 7 EDs. Family and friends expressing interest were also screened, and offered education and kits. In partnership with the state health department and standing orders, HCs dispensed naloxone rescue kits at no cost. Descriptive statistics and chi-square tests were used to analyze risk factor data collected on the screening forms over a 24-month period.
Outcomes : 5,458 individuals screened (89% patients, 9% family/friends, 3% ED employees), 1555 (29%) agreed to receive education and kit. Those accepting education and kit vs. those who refused, 46% reported using drugs for nonmedical reasons in the past year (vs 32%), 12% reported taking prescription pain relievers (vs. 4%), 10% reported receiving treatment for opioid use (vs. 2%), 18% experienced an opioid overdose (vs. 3%), and 59% had friends/family meeting one of the criteria (vs. 9%).