Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States
Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States
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DOI：
10.1111/j.1360-0443.2008.02182.x
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发表时间：
2008-06-01
期刊：
影响因子：
6
通讯作者：
Grau, Lauretta E.
中科院分区：
文献类型：
--
作者：
Green, Traci C.;Heimer, Robert;Grau, Lauretta E.
目的 本研究评估了美国接受过和未接受过药物过量反应培训的当前或前阿片类药物滥用者的药物过量和纳洛酮给药知识。设计和参与者 从六个站点中的每个站点招募 10 个人，平均分配给接受过药物过量识别和反应培训或未接受过药物过量识别和反应培训的人员（n = 62）。在巴尔的摩、旧金山、芝加哥、纽约和新墨西哥州制定美国过量用药培训和纳洛酮分发计划。测量 参与者完成了一份关于用药过量知识的简短调查问卷，其中包括对 16 种假定的用药过量场景进行评级的任务：(i) 是否发生用药过量，以及 (ii) 是否需要纳洛酮。双变量和多变量分析比较了受过训练的人和未经训练的人的结果。还使用加权和未加权 kappa 统计数据将回答与 11 名医学专家的回答进行了比较。研究结果 受访者主要为男性 (72.6%)； 45.8% 的人经历过服药过量，72% 的人曾目睹过服药过量。与未经培训的参与者相比，经过培训的参与者能够准确识别更多阿片类药物过量情况（t（60）= 3.76，P < 0.001）以及需要使用纳洛酮的情况（t（59）= 2.2，P < 0.05）。接受培训和识别阿片类药物过量迹象的较高感知能力与较高的过量识别分数独立相关。训练有素的受访者在识别阿片类药物过量情况（加权 kappa = 0.85）以及何时需要纳洛酮（kappa = 1.0）方面与医学专家一样熟练。结论 结果表明，美国的纳洛酮培训计划提高了参与者识别和应对社区阿片类药物过量的能力。吸毒者接受过量用药培训并对自己的反应能力充满信心，可以有效预防过量死亡。
Aims This study assessed overdose and naloxone administration knowledge among current or former opioid abusers trained and untrained in overdose-response in the United States. Design and participants Ten individuals, divided equally between those trained or not trained in overdose recognition and response, were recruited from each of six sites (n = 62). Setting US-based overdose training and naloxone distribution programs in Baltimore, San Francisco, Chicago, New York and New Mexico. Measurements Participants completed a brief questionnaire on overdose knowledge that included the task of rating 16 putative overdose scenarios for: (i) whether an overdose was occurring and (ii) if naloxone was indicated. Bivariate and multivariable analyses compared results for those trained to untrained. Responses were also compared to those of 11 medical experts using weighted and unweighted kappa statistics. Findings Respondents were primarily male (72.6%); 45.8% had experienced an overdose and 72% had ever witnessed an overdose. Trained participants recognized more opioid overdose scenarios accurately (t(60) = 3.76, P < 0.001) and instances where naloxone was indicated (t(59) = 2.2, P < 0.05) than did untrained participants. Receipt of training and higher perceived competency in recognizing signs of an opioid overdose were associated independently with higher overdose recognition scores. Trained respondents were as skilled as medical experts in recognizing opioid overdose situations (weighted kappa = 0.85) and when naloxone was indicated (kappa = 1.0). Conclusions Results suggest that naloxone training programs in the United States improve participants' ability to recognize and respond to opioid overdoses in the community. Drug users with overdose training and confidence in their abilities to respond may effectively prevent overdose mortality.