Organize and mobilize for implementation effectiveness to improve overdose education and naloxone distribution from syringe services programs: a randomized controlled trial

• Published in: Implementation science : IS 2024-02, Vol.19 (1), p.22-22, Article 22
• Main Authors: Lambdin, Barrot H, Bluthenthal, Ricky N, Garner, Bryan R, Wenger, Lynn D, Browne, Erica N, Morris, Terry, Ongais, Lee, Megerian, Cariné E, Kral, Alex H
• Format: Article
• Language: English
• Subjects: Best practice; Clinical trials; COVID-19; Distribution; Dosage and administration; Drug overdose; Drug Overdose - drug therapy; Drug Overdose - prevention & control; Drug use; Drugs; Education; Health Education; Heroin; Humans; Implementation science; Implementation strategy; Intervention; Methods; Mortality; Naloxone; Naloxone - therapeutic use; Narcotic Antagonists - therapeutic use; Narcotics; Opiate Overdose - drug therapy; Opioid-Related Disorders - drug therapy; Overdose; Overdose education and naloxone distribution; Syringe services programs; United States; United States Department of Veterans Affairs
• ISSN: 1748-5908; 1748-5908
• DOI: 10.1186/s13012-024-01354-y

The United States (US) continues to face decades-long increases in opioid overdose fatalities. As an opioid overdose reversal medication, naloxone can dramatically reduce opioid overdose mortality rates when distributed to people likely to experience or witness an opioid overdose and packaged with education on its use, known as overdose education and naloxone distribution (OEND). Syringe services programs (SSPs) are ideal venues for OEND with staff who are culturally competent in providing services for people who are at risk of experiencing or observing an opioid overdose. We carried out a randomized controlled trial of SSPs to understand the effectiveness of the organize and mobilize for implementation effectiveness (OMIE) approach at improving OEND implementation effectiveness within SSPs. Using simple randomization, 105 SSPs were enrolled into the trial and assigned to one of two study arms - (1) dissemination of OEND best practice recommendations (Control SSPs) or the OMIE approach along with dissemination of the OEND best practice recommendations (i.e., OMIE SSPs). OMIE SSPs could participate in 60-min OMIE sessions once a month for up to 12 months. At 12-month post-baseline, 102 of 105 SSPs (97%) responded to the follow-up survey. The median number of sessions completed by OMIE SSPs was 10. Comparing OMIE SSPs to control SSPs, we observed significant increases in the number of participants receiving naloxone (incidence rate ratio: 2.15; 95% CI: 1.42, 3.25; p