BOSTON- Opioid-related deaths continue to take the lives of thousands in the U.S. each year, with non-fatal opioid overdoses as a significant risk factor for a subsequent fatal overdose. Post-overdose interventions are emerging in affected communities, using what support systems are available to assist in the program design.
Survivors often do not seek treatment or overdose risk reduction services immediately after an overdose for many reasons, including shame and stigma, and lack of referrals to substance use treatment.
In a scoping review article published in Preventive Medicine , Sarah M. Bagley, MD, MSc, medical director of the CATALYST (Center for Addiction Treatment for Adolescents/Young adults who use Substances) Clinic and addiction specialist at Boston Medical Center's Grayken Center for Addiction, provides an overview about the emerging prevalence of post-overdose intervention programs in the U.S. and the variety of methods that communities and states are using based on availability of resources and support.
For the review, researchers examined articles published between 1999 and January 2019 that specifically described a specific post-overdose program. A total of 27 unique programs were identified for qualitative synthesis, which were organized into five categories based on timing, setting, and collaborations - emergency department-based, emergency department and home-based, home and/or overdose venue-based, mobile/not site-specific outreach, and diversion programs. Some of the key takeaways from the review are:
"We are at a time when post-overdose programs are imperative to supporting people who are struggling with opioid use disorder," said Bagley, who is also an assistant professor of medicine and pediatrics at Boston University School of Medicine. "It is important to engage individuals in care after they have survived an overdose so that we can provide the services and support necessary to reduce the risk of future overdose and prevent opioid-related fatalities in the U.S."
As more peer-based programs are implemented, further research should follow the role of collective responsibility with overdose risk reduction and treatment engagement. In addition, rigorous evaluation of existing and emerging programs is needed assess effectiveness of programs to reduce overdose and engage survivors in harm reduction and substance use disorder treatment.
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About Boston Medical Center
Boston Medical Center is a private, not-for-profit, 514-bed, academic medical center that is the primary teaching affiliate of Boston University School of Medicine. It is the largest and busiest provider of trauma and emergency services in New England. Committed to providing high-quality health care to all, the hospital offers a full spectrum of pediatric and adult care services including primary and family medicine and advanced specialty care with an emphasis on community-based care. Boston Medical Center offers specialized care for complex health problems and is a leading research institution, receiving more than $117 million in sponsored research funding in fiscal year 2016. It is the 13th largest recipient of funding in the U.S. from the National Institutes of Health among independent hospitals. In 1997, BMC founded Boston Medical Center Health Plan, Inc., now one of the top ranked Medicaid MCOs in the country, as a non-profit managed care organization. It does business in Massachusetts as BMC HealthNet Plan and as Well Sense Health Plan in New Hampshire, serving 290,000 people, collectively. Boston Medical Center and Boston University School of Medicine are partners in the Boston HealthNet – 14 community health centers focused on providing exceptional health care to residents of Boston. For more information, please visit http://www.bmc.org .
Preventive Medicine