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Inj Epidemiol. 2015 Dec;2(1):10. Epub 2015 May 22.

Effectiveness of bystander naloxone administration and overdose education programs: a meta-analysis.

Author information

1
Center for Injury Epidemiology and Prevention, Columbia University, 722 West 168th St, 5th Floor, New York, 10032, NY, USA.
2
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, 10032, NY, USA.
3
Department of Anesthesiology, Columbia University College of Physicians and Surgeons, 622 West 168th St, PH5-505, New York, 10032, NY, USA.
4
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, 10032, NY, USA. Charles.DiMaggio@nyumc.org.
5
Department of Surgery, New York University School of Medicine, 550, First Avenue, New York, NY, 10016, USA. Charles.DiMaggio@nyumc.org.

Abstract

The objective of this review was to assess the effectiveness of bystander naloxone administration and overdose education programs by synthesizing quantitative results reported in the research literature. Studies meeting predefined criteria were identified and reviewed, and their results were synthesized through meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for overdose recoveries for individuals who received naloxone dispensed by non-medical community members, and the standardized mean difference was calculated for test scores of non-medical volunteers who received training in overdose management versus the scores of untrained volunteers. Pooled data from four studies showed that naloxone administration by bystanders was associated with a significantly increased odds of recovery compared with no naloxone administration (OR = 8.58, 95% CI = 3.90 to 13.25). Data from five studies of overdose education indicated that average scores were significantly higher for trained participants than untrained participants for tests on naloxone administration, overdose recognition, and overdose response (standardized mean difference = 1.35, 95% CI = 0.92 to 1.77). Empirical evidence in the research literature suggests that bystander naloxone administration and overdose education programs are associated with increased odds of recovery and with improved knowledge of overdose recognition and management in non-clinical settings.

KEYWORDS:

Bystander; Naloxone; Opioid overdose; Overdose prevention

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