RESUMO
BACKGROUND: To help curb the opioid overdose epidemic, many states are implementing overdose education and naloxone distribution (OEND) programs. Few evaluations of these programs exist. Maryland's OEND program incorporated the services of the poison center. It asked bystanders to call the poison center within 2 hours of administration of naloxone. Bystanders included law enforcement (LE). OBJECTIVE: Description of the initial experience with this unique OEND program component. METHODS: Retrospective case series of all cases of bystander-administered naloxone reported to the Maryland Poison Center over 16 months. Cases were followed to final outcome, for example, hospital discharge or death. Indications for naloxone included suspected opioid exposure and unresponsiveness, respiratory depression, or cyanosis. Naloxone response was defined as person's ability to breathe, talk, or walk within minutes of administration. RESULTS: Seventy-eight cases of bystander-administered naloxone were reported. Positive response to naloxone was observed in 75.6% of overall cases. Response rates were 86.1% and 70.9% for suspected exposures to heroin and prescription opioids, respectively. Two individuals failed to respond to naloxone and died. DISCUSSION: Naloxone response rates were higher and admission to the intensive care unit rates were lower in heroin overdoses than prescription opioid overdoses. CONCLUSIONS: This retrospective case series of 78 cases of bystander-administered naloxone reports a 75.6% overall rate of reversal. SCIENTIFIC SIGNIFICANCE: The findings of this study may be more generalizable. Incorporation of poison center services facilitated the capture of more timely data not usually available to OEND programs. (Am J Addict 2016;25:301-306).
Assuntos
Analgésicos Opioides/intoxicação , Overdose de Drogas/prevenção & controle , Naloxona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Centros de Controle de Intoxicações/organização & administração , Serviços Preventivos de Saúde/organização & administração , Centros de Tratamento de Abuso de Substâncias/organização & administração , Adolescente , Adulto , Idoso , Overdose de Drogas/tratamento farmacológico , Feminino , Humanos , Masculino , Maryland , Pessoa de Meia-Idade , Serviços Preventivos de Saúde/métodos , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Centros de Tratamento de Abuso de Substâncias/métodos , Resultado do Tratamento , Adulto JovemRESUMO
Little is known about Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) rates in community-supervised juvenile justice-involved (CSJJI) females, or how to best provide screening for sexually transmitted infections in this population. A pilot intervention allowed case managers to offer optional CT/GC screening to CSJJI females during mandated visits. Anonymous satisfaction surveys and discussion groups assessed intervention acceptability. Case managers met with 514 CSJJI females; 102 (20%) agreed to screening and 117 tests were completed. Among those screened, 21 (18%) had CT and 3 (3%) had GC. Intervention feedback from case managers and clients was positive, but there were barriers to recruitment. Lessons learned from this case manager-facilitated intervention may increase the acceptability and effectiveness of future screening methods in this setting.