Abstract
Effective health education needs ongoing evidence to support policy development and action in a public health crisis, like the opioid epidemic in the United States. Opioid Education and Naloxone Distribution (OEND) programs work to change behaviors through information, education, and resources to empower people to prevent and respond to opioid overdose poisonings. In this review, we sought to identify the first aid educational components of OEND to address opioid overdose poisoning, identify gaps in the existing literature, and support the development of future studies that could then be systematically reviewed.From a systematic review that identified 2057 peer-reviewed manuscripts, 59 studies demonstrated that the educational literature is sparse, of low quality, lacks quality measures and effective methodologies, and suffers from self-reported and highly inconsistent endpoints, making outcome comparisons challenging, if not impossible. The reviewed OEND programs generally used a public health/health education approach focusing on people who inject opioids, their family and friends, first responders, and rarely the general public. Depending on the learners, interventions were broken down to those <15, 16-90, and >90 minutes, which categorically showed differences in knowledge and first aid response actions. Only eight studies used comparison groups which provide a slightly higher level of evidence. Reports of survival appeared to positively correlate with naloxone kit distribution. Opportunity exists to develop policies and plans that support individual and community efforts through evidence-based guidelines, particularly to the domains of first aid education, so that educators and organizations can deliver efficacious programming that meets the needs of their learners.
Highlights
BackgroundPoisoning from opioid overdoses is a public health epidemic in the United States (US), where opioids are implicated in almost 70% of all drug overdose deaths [1]
Increased rates of opioid use, abuse, and overdose have been reported across the globe [3,4], which raises a humanitarian concern for the political neutrality of first aid education, resource capacities, and public health educational interventions developed to mitigate the costs to the medical system, individuals, and society
We found an insufficient number of high-quality studies to support a more specific systematic review comparing one educational intervention versus another or no educational intervention at all
Summary
BackgroundPoisoning from opioid overdoses is a public health epidemic in the United States (US), where opioids are implicated in almost 70% of all drug overdose deaths [1]. Increased rates of opioid use, abuse, and overdose have been reported across the globe [3,4], which raises a humanitarian concern for the political neutrality of first aid education, resource capacities, and public health educational interventions developed to mitigate the costs to the medical system, individuals, and society. These interventions include the use of an opioid antagonist, such as naloxone, to counter the effects of opioid overdose [5,6,7]. Educational competencies and local implementation outcomes for effective OEND have not been systematically examined and remain an area of uncertainty in the development and implementation of optimal OEND programs [11,12]
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