A scoping review of post opioid-overdose interventions

Prev Med. 2019 Nov;128:105813. doi: 10.1016/j.ypmed.2019.105813. Epub 2019 Aug 19.

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Systematic Review

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Drug Overdose / drug therapy*
  • Drug Overdose / prevention & control*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Naloxone / therapeutic use*
  • Narcotic Antagonists / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / prevention & control*
  • Practice Guidelines as Topic
  • Preventive Health Services / standards*
  • United States
  • Young Adult

Substances

  • Analgesics, Opioid
  • Narcotic Antagonists
  • Naloxone