173. Brief Overdose Prevention Training For Adolescents Released From Juvenile Detention

Abstract

The purpose of the study was to evaluate the feasibility of providing naloxone and brief overdose prevention and harm reduction educational training to a high-risk population of teens in juvenile detention. We sought to evaluate rates of increased knowledge, confidence, and readiness regarding overdose prevention training with detained youth who report contact with opioid users. Training satisfaction was evaluated using qualitative measures. Residents at the Bernalillo County Youth Services Center (YSC), the juvenile detention center in Albuquerque, NM, were screened at the YSC medical clinic for exposure to opioid users and risk of witnessing an opioid overdose in their lives outside of YSC. The project was reviewed and approved by University of New Mexico Health Sciences Center IRB. Interested participants were enrolled and consented to participate in the study during the clinic visit. Participants completed a baseline assessment measuring demographic characteristics and knowledge and attitudes regarding Narcan and overdose prevention. Participants attended a one-on-one, patient centered training on recognizing an opioid overdose and conducting rescue procedures utilizing Narcan, a nasal spray delivery method of naloxone. Participants completed post-training measures of Narcan and overdose prevention knowledge and attitudes as well as measures of training satisfaction. The participants were then provided with a Narcan kit upon discharge from the YSC. Each Narcan kit contains two doses. Pre-post scores were compared using paired-sample t-tests and standardized effect sizes (Cohen’s d) were calculated to quantify the magnitude of change. 65% of the residents screened were eligible. Of those eligible, 100% agreed to participate. 30% were lost prior to baseline assessment because of release from YSC. Baseline knowledge of Narcan and overdose prevention was 6.3/10 on average (SD=1.2). Confidence in Narcan and overdose prevention was 6.7/10 (SD=2.7) and readiness to use Narcan was 6.4/10 (SD=3.9). After training, knowledge (7.7/10; SD=.5), confidence (7.9/10; SD= 1.8), and readiness (8.9/10; SD=1.3) all increased. All changes were statistically significant (p<.05). Standardized effect sizes were all in the moderate to large range (knowledge, d = 1.6, confidence, d=.5, readiness, d=.86). Satisfaction with the training was high. Qualitative assessment of satisfaction revealed several themes, including: general enthusiasm about the training; feelings of personal empowerment from having knowledge and ability to use Narcan; and desire to disseminate the information to friends and family on overdose prevention techniques and Narcan uses. Results suggest that implementation of Narcan and overdose prevention training with at-risk detention center teens is feasible and promising. Teens report high satisfaction and accurate recall of the training information. Feelings of confidence and readiness to use Narcan increased with the training. Potential is high for overdose prevention trainings to empower at-risk youth to save lives within communities. Future research will investigate the impact of Narcan and overdose prevention training on rates of actual overdose prevention in the community.