Intervention in an opioid overdose event increases interest in treatment among individuals with opioid use disorder

Abstract

Background: This study sought to explore whether intervening in suspected cases of opioid overdose alters interest in treatment for opioid use disorder (OUD). Data were collected as a part of a trial comparing the effects of different overdose education and naloxone distribution (OEND) training curricula on overdose outcomes. Methods: Following OEND training, participants completed four in-person follow-up visits at 1-, 3-, 6- and 12-months. Participants were also regularly contacted to inquire about overdose events they responded to, witnessed, or experienced themselves. Other assessments included the Addiction Severity Index that queries participants’ perceived importance of drug treatment on a scale of: 0 (Not at All) to 4 (Extremely). For the current secondary data analysis, treatment importance was assessed at the time points most immediately preceding and following participant intervention in an overdose event using naloxone. Results: The sample reported a mean duration of opioid use of 14.9 (± 11.5) years, with 67% having witnessed an overdose event prior to the study. Of the 321 enrolled, 92 participants used naloxone in response to 166 suspected cases of an opioid overdose. For the entire sample, mean treatment importance did not significantly change throughout the study. Among participants who utilized naloxone, treatment importance increased following the event (Before: 3.03, After: 3.39, p = 0.02). Due to the amount of time between the overdose event and assessment of post-event treatment importance (40.5 days, ±40.2), the current study most likely underestimates this effect. Conclusions: The current study suggests that responding to an overdose event increases interest in OUD treatment. Currently only considered an acute intervention to reduce overdose morbidity and mortality, OEND may have the potential to increase enrollment in medications to treat OUD. However, a prospective investigation needs to determine if the impact of an overdose event could be utilized to increase treatment engagement.

Keywords:

• Overdose
• naloxone
• opioid use disorder
• heroin

Acknowledgments

The authors would like to thank the study participants, along with the research team (Richard Eisenberg, Benjamin Foote, Gregory Cortorreal, Suky Martinez) who made this study possible.

Disclosure statement

In the past three years, Dr. Comer has received research funding from Alkermes, Braeburn Pharmaceuticals, Cerecor Inc., Corbus, Go Medical, Intra-cellular Therapies, and Lyndra. Dr. Comer has also consulted for: Alkermes, Charleston Labs, Clinilabs, Collegium, Depomed, Epiodyne, Mallinckrodt, Nektar, Newron, Opiant, Otsuka, and Sun Pharma. She also has received honoraria from the World Health Organization. Dr. Jones received compensation -in the form of partial salary support- from a study partially supported by Cerecor Inc., has served as a consultant to Alkermes, and is the recipient of an investigator-initiated grant from Merck Pharmaceuticals. The other authors have no conflicts to report.

Author contributions

The idea for this secondary data analysis was devised by JDJ, SDC, and ANC. Authors JDJ and RA performed the initial data analysis and wrote various sections of the manuscript. LB and FC also constructed first drafts of various sections of the manuscript. JDJ merged the various sections into a first draft, which all the authors reviewed and edited with JDJ preparing the final draft for submission.

Additional information

Funding

This study was supported by the National Institute on Drug Abuse grant R01DA035207 to Dr. Sandra Comer. Dr. Laura Brandt’s involvement in this trial was supported by the Erwin Schroedinger Fellowship from the Austrian Science Fund (ASF). The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.