Training Healthcare Providers to be Emergency Responders in Adolescent Opioid Overdose

Purpose: Drug overdose is now the preeminent cause of injury death in the U.S. Existing research suggests that adolescents are at increased risk for overdose because they are inexperienced with opioids, engage in polypharmacy, are still developing executive cognitive function, and are particularly susceptible to modeling by friends. Moreover, adolescent opioid misuse is strongly linked with adult heroin misuse. Opioid Overdose Education and Naloxone Distribution Trainings have been endorsed as the Evidence Based Practice (EBP), resulting in over 90% efficacy in reversing overdose, and up to 47% decrease in mortality from opioid overdose. Early trainings targeted injection users and police, but adolescents do not identify with injection users and are reluctant to call police. Teachers report they are not confident in their ability to detect or manage opioid overdose, yet they are ubiquitous in the environment of adolescents. This study suggests collaborating with schools to train healthcare providers who are proximal to youth, and often trusted, to create a cadre of first responders for adolescents.

Methods: All certificated and classified staff in a suburban middle class district in the NorthWest are invited to a single one hour in-person session comprised of a 10 minute pretest, a 40 minute training program based on best practices for educating adult learners and the harm reduction model, and a 10 minute post-test. Efficacy of training will be measured by changes in knowledge of signs and symptoms of opioid overdose, measured using the Opioid Overdose Knowledge Scale (OOKS), and attitudes towards opioid overdose, using the Opioid Overdose Attitudes Scale (OOAS).

Results: Research is in process. Demographic and experimental data will be presented using matched paired t-tests.

Conclusion: If results are consistent with those from Opioid Overdose Education and Naloxone Distribution trainings with other non-medically trained responders, the training will be implemented in other healthcare facilities, across the district and possibly with parent groups and staff at other agencies Marin adolescents have relationships with. The next step would be to introduce the pilot to pediatricians for use in training their staff who could then train their patients being prescribed opioids. Many Medical Officers of Health and community coalitions have already begun to respond to opioids in adults and are already integrated into statewide and professional organizations to diffuse this innovation more broadly.