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Prev Med. 2019 Aug 19:105813. doi: 10.1016/j.ypmed.2019.105813. [Epub ahead of print]

A scoping review of post opioid-overdose interventions.

Author information

1
Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA 02118, United States of America; Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine/Boston Medical Center, Boston, MA 02118, United States of America; Grayken Center for Addiction, Boston Medical Center, Boston, MA 02118, United States of America. Electronic address: sarah.bagley@bmc.org.
2
Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA 02118, United States of America.
3
Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston, MA 02118, United States of America; Grayken Center for Addiction, Boston Medical Center, Boston, MA 02118, United States of America.

Abstract

INTRODUCTION:

Nonfatal opioid overdose is a significant risk factor for subsequent fatal overdose. The time after a nonfatal overdose may provide a critical engagement opportunity to both reduce subsequent overdose risk and link individuals to treatment. Post-overdose interventions have emerged in affected communities throughout the United States (US). The objective of this scoping review is to identify US-based post-overdose intervention models (1) described in peer-reviewed literature and (2) implemented in public health and community settings.

METHODS:

Using the adapted PRISMA Checklist for Scoping Reviews, we searched PubMed, PsychInfo, Academic OneFile, and federal and state databases for peer-reviewed and gray literature descriptions of post-overdose programs. We developed search strings with a reference librarian. We included studies or programs with at least the following information available: name of program, description of key components, intervention team, and intervention timing.

RESULTS:

We identified a total of 27 programs, 3 from the peer-reviewed literature and 24 from the gray literature. 9 programs operated out of the ED, while 18 programs provided post-overdose support in other ways: through home or overdose location visits, mobile means, or as law enforcement diversion. Commonly, they include partnerships among public safety and community service providers.

CONCLUSIONS:

Programs are emerging throughout the US to care for individuals after a nonfatal opioid overdose. There is variability in the timing, components, and follow-up in these programs and little is known about their effectiveness. Future work should focus on evaluation and testing of post-overdose programs so that best practices for care can be implemented.

KEYWORDS:

Analgesics; Community-institutional relations; Drug overdose; Drug users; Emergency service; Health services; Hospital; Law enforcement opioid overdose intervention; Naloxone; Opioid; Opioid overdose; Poisoning; Post-overdose intervention; Substance-related disorders

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