@article{a91df327f3304129ac6b9a2eacea89e4,
title = "Impacts of an opioid overdose prevention intervention delivered subsequent to acute care",
abstract = "Background Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons. Methods Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting for time at risk. Results During the follow-up period, 24% of the 241 participants had at least one overdose event, 85% had one or more ED visits and 55% had at least one hospitalisation, with no significant differences between intervention and comparison groups. The instantaneous risk of an overdose event was not significantly lower for the intervention group (sub-HR: 0.83; 95% CI 0.49 to 1.40). Discussion These null findings may be due in part to the severity of the population in terms of housing insecurity (70% impermanently housed), drug use, unemployment and acute healthcare issues. Given the high overdose and healthcare utilisation rates, more intensive interventions, such as direct referral and provision of housing and opioid agonist treatment medications, may be necessary to have a substantial impact on opioid overdoses for this high-acuity population in acute care settings.",
keywords = "behavior change, drugs, health education",
author = "Banta-Green, {Caleb J.} and Coffin, {Phillip O.} and Merrill, {Joseph O.} and Sears, {Jeanne M.} and Chris Dunn and Floyd, {Anthony S.} and Whiteside, {Lauren K.} and Yanez, {Norbert D.} and Donovan, {Dennis M.}",
note = "Funding Information: 1Alcohol & Drug Abuse Institute and Department of Health Services, School of Public Health University of Washington, Seattle, Washington, USA 2Substance Use Research, San Francisco Department of Public Health, San Francisco, California, USA 3Department of Medicine, University of California San Francisco, San Francisco, California, USA 4Department of Medicine, University of Washington, Seattle, Washington, USA 5Department of Health Services, School of Public Health and Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA 6Institute for Work and Health, Toronto, Ontario, Canada 7Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington, USA 8Alcohol & Drug Abuse Institute and Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA 9Department of Emergency Medicine, University of Washington, Seattle, Washington, USA 10Oregon Health & Science University/Portland State University School of Public Health, Oregon Health & Science University, Portland, Oregon, USA 11Alcohol & Drug Abuse Institute and Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington, USA Acknowledgements We would like to thank: Barbara Burke, Leslie Enzian, Shira Hasson-Schiff, Sheree Miller, Susan Stern, Steve Mitchell, MelissaPhares, Jeff Purcell, Harborview Emergency Department, Harborview Adult Medicine Clinic, Harborview Respite Program at Jefferson Terrace (Edward Thomas House), Data Safety Monitoring Oversight Committee and Administrative Support Staff at the UW Alcohol and Drug Abuse Institute. Contributors CJB-G, POC, JOM, CD, DMD, NDY and ASF substantially contributed to the conception and design of the study. CJB-G, ASF, JMS and LKW also contributed to acquiring data. All authors were involved in analysis and interpretation of the data, drafting and revising the article and provided final approval of the submitted manuscript. Funding Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number 1R01A030351. Study data were collected and managed using REDCap electronic data capture tools hosted at the Institute of Translational Health Sciences. REDCap at ITHS is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1 TR002319. Publisher Copyright: {\textcopyright} 2019 Article author(s). All rights reserved.",
year = "2019",
month = jun,
day = "1",
doi = "10.1136/injuryprev-2017-042676",
language = "English (US)",
volume = "25",
pages = "191--198",
journal = "Injury Prevention",
issn = "1353-8047",
publisher = "BMJ Publishing Group",
number = "3",
}