Grant: Project Grant

Overdose deaths from opioids like heroin, oxycodone and fentanyl have reached record levels in North America and account for over 100,000 deaths per year worldwide. Overdose often affects young people, resulting in more years of life lost than HIV, pneumonia or influenza in Ontario. Overdose education and naloxone distribution (OEND) is a promising way to address this epidemic. OEND programs train laypeople to recognize overdose and give first aid, including the opioid antidote naloxone. Conventional OEND programs are mainly available through non-clinical community harm reduction centers, involve lengthy patient training, and do not reach many of the patients at risk of overdose. OEND is being expanded to hospitals, clinics, and emergency departments, but little is known about how to offer OEND in these settings effectively. We do not know if this intervention affects patient knowledge or outcomes, and OEND programs have not been well evaluated in clinical practice. This project will generate tools and evidence to extend OEND into clinical care in emergency departments, family practices, opioid substitution clinics and inpatient settings. Scientists will work with design experts and community members to create an OEND toolkit that allows brief patient training with a new naloxone delivery device, and test the toolkit using a randomized trial. We will recruit patients at risk of opioid overdose in the emergency department, family practices, opioid substitution clinics and inpatient settings to be trained using the new toolkit or referred to a conventional community OEND program. Then we will compare their performance in a mock opioid overdose with a manikin. We will work with affected communities to share project results in Canada and abroad. The study will let us examine other effects of OEND including deaths, hospital admissions, and cost. The project will transform care for thousands of Canadians by incorporating overdose prevention into routine clinical care.