ER Visits Can Help Reduce Opiod Deaths With Education, Rescue Kits

Emergency departments (ED) have the opportunity to play a key role in preventing opioid deaths by offering overdose education and explaining how one should respond while witnessing an overdose, according to a new study published in the Western Journal of Emergency Medicine.

As part of this effort, ED’s also have the potential to equip patients with nasal naloxone rescue kits.

The study is the first to demonstrate the potential positive outcome of ED-based opioid overdose prevention education and naloxone distribution to trained laypersons, patients, and their social network.

Deaths from prescription opioid overdose increased in the U.S. from 4,041 people in 1999 to 16,651 in 2010. In 2011, an estimated 420,040 ED visits were related to overdose of prescription opioids and 258,482 heroin overdoses.

Since 1993, Boston Medical Center’s (BMC) Project ASSERT has offered alcohol and drug use screening, brief intervention and referral to treatment to patients treated for intoxication in the ED.

In 2009, Project ASSERT, with support from Boston Public Health Commission and Massachusetts Department of Public Health, also began offering overdose prevention education and naloxone rescue kits to emergency department patients at risk for opioid overdose.

In an effort to evaluate the usefulness of this program and describe the overdose risk knowledge, opioid use, and overdose response actions among patients receiving overdose prevention education, researchers from Boston University School of Medicine (BUSM) and BMC conducted a telephone survey of Project ASSERT patients.

Of the 415 patients who had been given overdose education, 51 patients were surveyed. Of these 51 patients, 73 percent had received a naloxone rescue kit either in the emergency department or elsewhere, such as a detox facility. About one third of them reported opioid use within the last 30 days.

Furthermore, more than half had reported witnessing an overdose and calling 911 for help. Among those with naloxone rescue kits, about one-third administered naloxone during the rescue.

“This study confirms that the emergency department provides a promising opportunity for opioid overdose harm reduction measures through overdose education and naloxone rescue kit distribution,” said lead author Kristin Dwyer, M.D., emergency physician at BMC.

“Our program reached a high-risk population that commonly witnessed overdoses, called for help and used naloxone to rescue people, when available,” she added.

Although the study was retrospective with a low response rate, the researchers believe the findings should lead to larger studies and programs to further evaluate the benefits and harms of overdose prevention efforts in EDs.

Source: Boston University Medical Center