Results: Study results were then synthesized, qualitatively, and within the current research, there is overwhelming support of take-home naloxone programs being effective in preventing fatal opioid overdoses. Bornstein KJ, Coye AE, St Onge JE, Li H, Muller A, Bartholomew TS, Tookes HE. There was one randomized controlled pilot study included, which had to be ceased because of most naloxone administration being used on other people rather than the person it was dispensed to (Parmar et al., 2017). Naloxone is known to reverse the effects of opioids in an overdose, and studies show evidence that communities with THN programs have decreased mortality from ORDs as compared with communities without these programs. Further studies are needed to be done using a different design method to better establish if NOR decreases mortality from opioid overdose after prison release as this population is at a high risk for overdose. NLM Opioid Overdose Prevention Programs Providing Naloxone to Laypersons - United States, 2014. Addiction. Information was collected from death certificates and hospital discharge codes to determine overdose rates by community. Through evaluation, a 95% confidence interval was determined for ORDs in relation to prison release and prison release/hospital discharge as 36% and 22% reduction, respectively (Bird et al., 2016). There were 1,685 participants randomized between May 28, 2012, and December 8, 2014. Journal of Addictions Nursing, 27(3), 160-179. http://dx.doi.org/doi:10.1097/JAN.0000000000000132[Context Link], Morrone W. R. (2016). Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids-Conception and maturation. Factors Associated With Participation in an Emergency Department-Based Take-Home Naloxone Program for At-Risk Opioid Users. A seventh study for inclusion by Bird, McAuley, Perry, and Hunter examined the effectiveness of Scotland's National Naloxone Program (NNP) in relation to ORDs as a pre-post design (Bird et al., 2016). One final limitation to note is that recall bias may exhibit an effect due to the retrospective design of the study. 2020 Apr 1:10.1097/JXX.0000000000000371. Randomized controlled pilot trial of naloxone-on-release to prevent post-prison opioid overdose deaths. Purpose: Opioid abuse and overdose is a public health concern as it relates to increased morbidity and mortality. The results of the 19 communities studied were 2,912 individuals enrolled in the OEND programs, and 327 rescue attempts were made at a 98% success rate (Walley et al., 2013). In one study evaluating the effects of naloxone on fetal behavior, 54 pregnant women near term received either 0.4 mg of naloxone or placebo. Key words used were "programs or take-home kits," "Narcan or Naloxone," and "mortality." Naloxone take-home kits (THKs) are becoming available to the public and laypersons, and there are more programs being established providing these kits as well as corresponding education on proper use and signs of opioid overdose (McDonald & Strang, 2016). The authors identified six themes from the emerging research studies: global trends, U.S. overdose education programs with naloxone distribution, barrier to naloxone distribution, political opposition and support, financial impact, and recommendations. Connect with us on Facebook, Twitter, Linkedin, YouTube, Pinterest, and Instagram. Prescription opioid misuse, heroin, and fentanyl. This systematic review focuses on the application of take-home naloxone programs and its association with decreased mortality among those who abuse opioids. Furthermore, the evaluation of the Bradford Hill's criteria for causality was met in terms of strength, consistency, specificity, analogy, biological gradient, and plausibility, and partially met were temporality, coherence, and experiment (Bird et al., 2016). doi: 10.1371/journal.pone.0227298. Our aim was to assess the expected outcomes and cost-effectiveness of distributing naloxone to heroin users Evaluation of buprenorphine/naloxone dose and use of sedating supportive medication on treatment outcomes in veterans with opioid use disorder Amber Kapuganti , PharmD, BCPP, 1 Traci Turner , PharmD, BCPP, 2 and Christopher J. Thomas , PharmD, BCPS, BCPP 3 The authors cite successful opioid-drug overdose prevention programs within California, Massachusetts, Pennsylvania, and New York, specifically San Francisco, which had a reported 89% success rate with naloxone (Mitchell & Higgins, 2016). Randomization can be viewed as unethical in withholding naloxone, a lifesaving medication, among this population who are at risk for overdose. As a result, there is an implication for a practice change that take-home naloxone programs should be more widely implemented throughout communities as a method of decreasing mortality associated with opioid overdoses. One limitation of this descriptive meta-analysis and systematic review is that it is noted to have a lack of randomized controlled trials partly due to ethical concerns. Naloxone can quickly restore normal breathing to a person if their breathing has slowed or … International Journal of Drug Policy, 26(12), 1183-1188. http://dx.doi.org/http://dx.doi.org/10.1016/j.drugpo.2015.09.011[Context Link], McDonald R., Campbell N. D., Strang J. The researchers were then able to calculate a proportion of use, which is needed for public health planners when determining resource allocation in regard to people who use drugs. The Bradford Hill evaluation consists of nine criteria in which to evaluate causality when only correlational data exist (McDonald & Strang, 2016). Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: Interrupted time series analysis. Increases in drug and opioid-involved overdose deaths-United States, 2010-2015. Within this systematic review and meta-analysis, four of the above studies were utilized for this particular systematic review (Bennett & Holloway, 2012; Clark et al., 2014; EMCDDA, 2015; Walley et al., 2013). The study did find positive enrollment and, participants felt safer in their heroin use with naloxone (Parmar et al., 2017). (2013). The only randomized controlled study found for inclusion was on the effectiveness of naloxone in the reduction of opioid overdose deaths, the pilot N-ALIVE study conducted in Scotland and England (Parmar, Strang, Choo, Meade, & Bird, 2017). The final two outcomes the authors wanted to examine were how overdoses were managed with the use of naloxone versus how overdoses were managed without the use of naloxone (Bennett & Holloway, 2012). Participants were tested before and after training regarding THKs, and follow-up was through refill requests. Through this, the researchers were able to determine that the decrease in ORDs during this period was associated with the initiation of the NNP. 2016 Jul;111(7):1177-87. doi: 10.1111/add.13326. This study by McAuley et al. Methods: The purpose of this systematic review was to determine if programs that supply take-home naloxone are effective in preventing fatal overdoses among those who abuse opioids. Preventing opiate overdose deaths: examining objections to take-home naloxone. NIH 2017 Mar;69(3):340-346. doi: 10.1016/j.annemergmed.2016.07.027. Main aims that the researchers sought to examine were fourfold: summarize the power of Scotland's NNP as a before/after evaluation as determined by primary and secondary outcomes, appraise the evidence for the NNP's effectiveness, assess for causality via Bradford Hill's criteria, and estimate the cost-effectiveness of the NNP in terms of quality-adjusted life years as a gain of 1-10 years (Bird et al., 2016).

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