Opioid-related deaths continue to take the lives of thousands in the U.S. each year, with non-fatal opioid overdoses as a significant risk factor for a subsequent fatal overdose. Post-overdose interventions are emerging in affected communities, using what support systems are available to assist in the program design.
Survivors often do not seek treatment or overdose risk reduction services immediately after an overdose for many reasons, including shame and stigma, and lack of referrals to substance use treatment.
In a scoping review article published inPreventative Medicine, Sarah M. Bagley, MD, MSc, medical director of the CATALYST (Center for Addiction Treatment for Adolescents/Young adults who use Substances) Clinic and addiction specialist at Boston Medical Center's Grayken Center for Addiction, provides an overview about the emerging prevalence of post-overdose intervention programs in the U.S. and the variety of methods that communities and states are using based on availability of resources and support.
For the review, researchers examined articles published between 1999 and January 2019 that specifically described a specific post-overdose program. A total of 27 unique programs were identified for qualitative synthesis, which were organized into five categories based on timing, setting, and collaborations -- emergency department-based, emergency department and home-based, home and/or overdose venue-based, mobile/not site-specific outreach, and diversion programs. Some of the key takeaways from the review are:
"We are at a time when post-overdose programs are imperative to supporting people who are struggling with opioid use disorder," said Bagley, who is also an assistant professor of medicine and pediatrics at Boston University School of Medicine. "It is important to engage individuals in care after they have survived an overdose so that we can provide the services and support necessary to reduce the risk of future overdose and prevent opioid-related fatalities in the U.S."
As more peer-based programs are implemented, further research should follow the role of collective responsibility with overdose risk reduction and treatment engagement. In addition, rigorous evaluation of existing and emerging programs is needed assess effectiveness of programs to reduce overdose and engage survivors in harm reduction and substance use disorder treatment.
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