Incorporation of poison center services in a state-wide overdose education and naloxone distribution program.

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).

A novel approach to informing the public about the risks of overdose and nonmedical use of prescription medications.

BACKGROUND: Poison centers answer telephone calls from persons requesting identification of tablets. Many of these calls are from people for whom the tablets were not prescribed and potentially represent nonmedical use. Implementation of a telephone-based program of overdose prevention and screening for nonmedical use of prescription medications is examined. METHODS: Social workers with experience in substance abuse disorders were hired by a poison center to answer telephone calls from persons asking for tablet identification. The social workers asked questions regarding demographics, provided the ingredients, provided overdose prevention/safety information, and offered referral to treatment to callers who desired it. RESULTS: A total of 17,616 tablet identification calls from the public were answered by the social workers during the 20-month study period. Most callers were Caucasian with median age 33 years (range 18-93 years). Overdose prevention/safety information, aimed mostly at reducing polydrug use, was delivered to 6,635 (37.7%) callers. CONCLUSIONS: Treatment resource information was provided to 3,775 (21.4%) callers. A telephone-based service made up of social workers interacted with several thousand individuals potentially at risk for adverse outcomes from nonmedical use of prescription medications and delivered overdose/safety information. Although further study is needed, this type of service can complement existing state/community efforts aimed at education regarding the nonmedical use of prescription medications.