Feasibility of Bystander Administration of Public-Access Naloxone for Opioid Overdose

Pre-stationing naloxone, a competitive antagonist that can reverse the effects of opioid overdose, in public spaces may expedite antidote delivery. Our study aimed to determine the feasibility of bystander-assisted overdose treatment using pre-stationed naloxone. Convenience sample of bystanders in...

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Bibliographic Details
Published in:Prehospital emergency care 2018-11, Vol.22 (6), p.788-794
Main Authors: Goldberg, Scott A, Dworkis, Daniel A, Liao, Vincent T, Eyre, Andrew J, Albert, Jack, Fawcett, Meghan M, Narovec, Conor M, DiClemente, James, Weiner, Scott G
Format: Article
Language:English
Subjects:
Adult
Aged
Analgesics, Opioid - administration & dosage
Drug Overdose - drug therapy
Emergency Medical Services
Feasibility Studies
Female
Health Services Accessibility
Helping Behavior
Humans
Male
Middle Aged
Naloxone - administration & dosage
Naloxone - therapeutic use
Narcotic Antagonists - administration & dosage
Narcotic Antagonists - therapeutic use
Public Facilities
Substance-Related Disorders - drug therapy
Young Adult
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Summary:Pre-stationing naloxone, a competitive antagonist that can reverse the effects of opioid overdose, in public spaces may expedite antidote delivery. Our study aimed to determine the feasibility of bystander-assisted overdose treatment using pre-stationed naloxone. Convenience sample of bystanders in Cambridge, Massachusetts in April 2017. Subjects assisted a simulated patient described as unconscious. Subjects interacted with simulated EMS dispatch to locate a nearby box, unlock it, and administer naloxone. Fifty participants completed the simulation. Median time from simulated ambulance dispatch to naloxone administration was 189 seconds, and from arrival at patient side to administration 61 seconds. All but one participant (98.0%) correctly administered naloxone. Subjects' comfort with administration and willingness to provide medical care increased from before to after the trial. Comfort in administering naloxone varied significantly with level of previous training prior to, but not following, study participation. Bystanders are willing and able to access pre-stationed naloxone and administer it to a simulated patient in a public space. Public access naloxone stations may be a useful tool to reduce time to naloxone administration, particularly in areas where opioid overdoses are clustered.
ISSN:1090-3127
1545-0066
DOI:10.1080/10903127.2018.1461284