Abstract
The objective of this review was to assess the effectiveness of bystander naloxone administration and overdose education programs by synthesizing quantitative results reported in the research literature. Studies meeting predefined criteria were identified and reviewed, and their results were synthesized through meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for overdose recoveries for individuals who received naloxone dispensed by non-medical community members, and the standardized mean difference was calculated for test scores of non-medical volunteers who received training in overdose management versus the scores of untrained volunteers. Pooled data from four studies showed that naloxone administration by bystanders was associated with a significantly increased odds of recovery compared with no naloxone administration (OR = 8.58, 95% CI = 3.90 to 13.25). Data from five studies of overdose education indicated that average scores were significantly higher for trained participants than untrained participants for tests on naloxone administration, overdose recognition, and overdose response (standardized mean difference = 1.35, 95% CI = 0.92 to 1.77). Empirical evidence in the research literature suggests that bystander naloxone administration and overdose education programs are associated with increased odds of recovery and with improved knowledge of overdose recognition and management in non-clinical settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-015-0041-8) contains supplementary material, which is available to authorized users.
Highlights
The population-based death rate from drug overdose in the United States has increased dramatically over the last two decades, primarily due to an increase in deaths involving opioid analgesics (CDC 2014a,b,c)
This study presents a systematic review of the literature on bystander and non-medical administration of naloxone, synthesizes the effect estimates of studies reporting quantitative outcomes, and reports on the effectiveness of naloxone administration by bystanders in reversing overdoses as well as whether overdose response training increases knowledge of overdose recognition and management
Description of included studies Four studies contributed to the analysis on bystander naloxone administration (Strang et al 2008; Lankenau et al 2013; McAuley et al 2010; Galea et al 2006)
Summary
The population-based death rate from drug overdose in the United States has increased dramatically over the last two decades, primarily due to an increase in deaths involving opioid analgesics (CDC 2014a,b,c). In 2013 (the last year for which data are available), national data indicate that drug overdose claimed 43,982 lives, 81.1% of which were coded as unintentional Overdoses involving opioid analgesics accounted for 36.9% of all drugpoisoning deaths National vital statistics system mortality data 2015). Opioid overdose deaths are avoidable if the antagonist naloxone is administered in time. Naloxone has been the standard treatment for overdose effects like respiratory
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