Abstract
IntroductionThe BC Centre for Disease Control implemented the Facility Overdose Response Box (FORB) program December 1st, 2016 to train and support non-healthcare service providers who may respond to an overdose in the workplace. The program aims to support staff at non-profit community-based organizations by ensuring policy development, training, practice overdose response exercises, and post-overdose debriefing opportunities are established and implemented.Materials and methodsThree data sources were used in this descriptive cross-sectional study: FORB site registration data; naloxone administration forms; and a survey that was distributed to FORB sites in February 2019. FORB program site and naloxone administration data from December 1st, 2016 to December 31st, 2019 were analyzed using descriptive statistics. A Cochran-Armitage test was used to assess trends over time in naloxone administration event characteristics. Site coordinator survey results are reported to supplement findings from administrative data.ResultsAs of December 31st, 2019, FORB was implemented at 613 sites across BC and 1,758 naloxone administration events were reported. The majority (86.3%, n = 1,517) were indicated as overdose reversals. At registration, 43.6% of sites provided housing services, 26.3% offered harm reduction supplies, and 18.6% provided Take Home Naloxone. Refusal to be transported to hospital following overdose events when emergency services were called showed an increasing trend over time. Most respondents (81.3%) reported feeling confident in their ability to respond to the overdose and 59.6% were offered staff debrief. Based on the 89 site survey responses, supports most commonly made available following an overdose were debrief with a fellow staff member (91.0%), debrief with a supervisor (89.9%), and/or counselling services (84.3%).ConclusionsThe uptake of the FORB program has contributed to hundreds of overdose reversals in community settings in BC. Findings suggest that the FORB program supports developing staff preparedness and confidence in overdose response in community-based settings.
Highlights
The British Columbia (BC) Centre for Disease Control implemented the Facility Overdose Response Box (FORB) program December 1st, 2016 to train and support non-healthcare service providers who may respond to an overdose in the workplace
As of December 31st, 2019, FORB was implemented at 613 sites across BC and 1,758 naloxone administration events were reported
The uptake of the FORB program has contributed to hundreds of overdose reversals in community settings in BC
Summary
Three data sources were used in this descriptive cross-sectional study: FORB site registration data; naloxone administration forms; and a survey that was distributed to FORB sites in February 2019. FORB program site and naloxone administration data from December 1st, 2016 to December 31st, 2019 were analyzed using descriptive statistics. BCHRS works closely with Regional Health Authority Harm Reduction Coordinators who identify eligible organizations or sites and provide support in registration and initial staff training. Sites that are eligible to participate in the FORB program are non-profit and communitybased organizations across BC that work with individuals at risk of experiencing an opioid overdose. BCHRS operates the FORB program and is responsible for enrolling FORB sites, supplying overdose response boxes, naloxone, and replacement or training supplies to be kept at the site. Prior to receiving overdose response boxes, sites are required to develop an overdose response policy and protocol for their organization and create a training plan for staff. Sites are responsible for training their staff to administer naloxone, providing support and debriefing to staff following an overdose response, and providing ongoing training and practice drills to maintain staff competency [14, 15]
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