Naloxone knowledge, interest, and obtainment among a general emergency department patient population

Abstract

BackgroundOpioid overdose education and naloxone distribution (OEND) programs are an effective approach for reducing opioid overdose deaths. However, research on the effectiveness of these programs generally focus on those most at risk of overdose, with less knowledge about a general patient population. MethodsWe administered survey on knowledge of and interest in naloxone, as well as risk of engaging in opioid-related aberrant behaviors via the Opioid Risk Tool (ORT), to a convenience sample of emergency department patients. Demographics and survey answers were compared with 1) The patient's interest in a possible free naloxone kit (baseline), 2) The patient independently obtaining a naloxone kit (30-day follow-up), and 3) The patient reporting circumstances where naloxone could have been useful (30-day follow-up), as analyzed with chi-square testing. ResultsOf 948 ED patients, a majority (65.1 %) were interested in a possible kit, while 5.2 % at follow-up had obtained a kit independently, and 2.5 % reported circumstances where naloxone could have been useful. Male patients were less likely to show interest in a free kit (odds ratio 0.731), and those with a gender identity other than male or female had higher ORT scores. ORT score was positively associated with interest in naloxone, with weaker positive associations with other outcome variables. Knowledge of naloxone, naloxone access, having a friend/family member who uses opioids or who died of an overdose were associated with interest in and/or obtaining naloxone, but not circumstances where naloxone could have been useful, while knowledge of where to obtain naloxone was associated with the latter. Circumstances where naloxone could be useful were further associated with relationship status, with divorce associated with this being more likely (OR 3.790), and marriage/domestic partnership being protective of such (OR 0.302). ConclusionsThe general ED patient population does not always share characteristics of groups that are typically the subject of OEND studies. It appears social factors including gender, family members/friends, and relationship status are important factors for understanding interest in naloxone, obtaining naloxone, and experiencing circumstances where naloxone could be useful.