TY - JOUR
KW - Drug Overdose/drug therapy
KW - Emergency Service, Hospital/organization & administration
KW - Humans
KW - Naloxone/therapeutic use
KW - Narcotic Antagonists/therapeutic use
KW - Opioid-Related Disorders/drug therapy
KW - Program Evaluation
KW - United States
AU - A. H. Gunn
AU - Z. P. W. Smothers
AU - N. Schramm-Sapyta
AU - C. E. Freiermuth
AU - M. MacEachern
AU - A. J. Muzyk
A1 - 
AB - Introduction: Substance use disorders, including opioid use disorders, are a major public health concern in the United States. Between 2005 and 2014, the rate of opioid-related emergency department (ED) visits nearly doubled, from 89.1 per 100,000 persons in 2005 to 177.7 per 100,000 persons in 2014. Thus, the ED presents a distinctive opportunity for harm-reduction strategies such as distribution of naloxone to patients who are at risk for an opioid overdose. Methods: We conducted a systematic review of all existing literature related to naloxone distribution from the ED. We included only those articles published in peer-reviewed journals that described results relating to naloxone distribution from the ED. Results: Of the 2,286 articles we identified from the search, five met the inclusion criteria and had direct relevance to naloxone distribution from the ED setting. Across the studies, we found variation in the methods of implementation and evaluation of take-home naloxone programs in the ED. In the three studies that attempted patient follow-up, success was low, limiting the evidence for the programs' effectiveness. Overall, in the included studies there is evidence that distributing take-home naloxone from the ED has the potential for harm reduction; however, the uptake of the practice remained low. Barriers to implementation included time allocated for training hospital staff and the burden on workflow. Conclusion: This systematic review of the best evidence available supports the ED as a potential setting for naloxone distribution for overdose reversal in the community. The variability of the implementation methods across the studies highlights the need for future research to determine the most effective practices.
BT - The western journal of emergency medicine
C5 - Opioids & Substance Use
CP - 6
CY - United States
DO - 10.5811/westjem.2018.8.38829
IS - 6
JF - The western journal of emergency medicine
N2 - Introduction: Substance use disorders, including opioid use disorders, are a major public health concern in the United States. Between 2005 and 2014, the rate of opioid-related emergency department (ED) visits nearly doubled, from 89.1 per 100,000 persons in 2005 to 177.7 per 100,000 persons in 2014. Thus, the ED presents a distinctive opportunity for harm-reduction strategies such as distribution of naloxone to patients who are at risk for an opioid overdose. Methods: We conducted a systematic review of all existing literature related to naloxone distribution from the ED. We included only those articles published in peer-reviewed journals that described results relating to naloxone distribution from the ED. Results: Of the 2,286 articles we identified from the search, five met the inclusion criteria and had direct relevance to naloxone distribution from the ED setting. Across the studies, we found variation in the methods of implementation and evaluation of take-home naloxone programs in the ED. In the three studies that attempted patient follow-up, success was low, limiting the evidence for the programs' effectiveness. Overall, in the included studies there is evidence that distributing take-home naloxone from the ED has the potential for harm reduction; however, the uptake of the practice remained low. Barriers to implementation included time allocated for training hospital staff and the burden on workflow. Conclusion: This systematic review of the best evidence available supports the ED as a potential setting for naloxone distribution for overdose reversal in the community. The variability of the implementation methods across the studies highlights the need for future research to determine the most effective practices.
PP - United States
PY - 2018
SN - 1936-9018; 1936-900X
SP - 1036
EP - 1042
EP - 
T1 - The Emergency Department as an Opportunity for Naloxone Distribution
T2 - The western journal of emergency medicine
TI - The Emergency Department as an Opportunity for Naloxone Distribution
U1 - Opioids & Substance Use
U2 - 30429939
U3 - 10.5811/westjem.2018.8.38829
VL - 19
VO - 1936-9018; 1936-900X
Y1 - 2018
ER -