Promoting opioid overdose prevention and recovery: An exploratory study of an innovative intervention model to address opioid abuse
Promoting opioid overdose prevention and recovery: An exploratory study of an innovative intervention model to address opioid abuse
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DOI：
10.1016/j.drugpo.2018.12.004
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发表时间：
2019-02-01
影响因子：
4.4
通讯作者：
Hallcom, Donald
中科院分区：
文献类型：
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作者：
Powell, Kristen Gilmore;Treitler, Peter;Hallcom, Donald
背景资料：致命的阿片类药物过量是美国的一个国家公共卫生问题，也是新泽西成瘾治疗系统面临的一个关键问题。新泽西制定了一项创新计划，阿片类药物过量恢复计划（OORP），以解决流行病和非致命性过量后治疗率低的问题。OORP利用具有同行恢复专家（RS）和患者导航员（PN）的干预模型，在阿片类药物过量逆转后立即与急诊科（ED）内的个人进行接触。这个探索性的S/tudy的目的是检查的过程中，通过它的OORP是在其第一年实施，并确定促进者和障碍的implementation.Methods：数据收集在2016-2017年，通过17个电话访谈和焦点小组与39名参与者。参与者是通过有目的的非随机抽样选择的OORP工作人员和利益相关者。使用了标准化、开放式访谈指南。进行专题分析，以确定，分析和报告的整体patterns.Results：与会者详细的故事，从外地和决策者照亮了实施过程。调查结果显示，治疗的后勤障碍包括患者缺乏保险和手机，缺乏立即可用的排毒床，以及由于医疗条件而导致一些患者不符合计划。使用同龄人作为第一反应者的模型产生了积极的影响，因为他们的成瘾经验使他们能够更成功地与患者接触。PNs是至关重要的，在解决高需求的情况下管理和转介和外部合作伙伴也是重要的implementation.Conclusions：结果强调需要努力将这一重要的模式内ED作为一个多层次的方法来解决阿片类药物滥用的一部分。确定的挑战导致全州的战略规划和进一步发展的领域。OORP是一种很有前途的干预措施，可能会增加与同伴支持，治疗和康复有关的阿片类药物障碍患者的数量。
Background: Fatal opioid overdose is a national public health concern in the United States and a critical problem confronting New Jersey's addiction treatment system. New Jersey developed an innovative program, the Opioid Overdose Recovery Program (OORP), to address the epidemic and the issue of low treatment admissions following a non-fatal overdose. The OORP utilizes an intervention model with peer recovery specialists (RSs) and patient navigators (PNs) to engage individuals within emergency departments (EDs) immediately following an opioid overdose reversal. The purpose of this exploratory s/tudy was to examine the process through which the OORP was implemented in its first year and determine facilitators and barriers to implementation.Methods: Data were collected in 2016-2017, through 17 telephone interviews and focus groups with 39 participants. Participants were OORP staff and stakeholders selected through purposeful, non-random sampling. Standardized, open-ended interview guides were used. Thematic analysis was conducted to identify, analyze, and report overall patterns.Results: Participants detailed stories from the field and policymakers illuminated the process of implementation. Findings revealed logistical barriers to treatment including patients' lack of insurance and cell phones, lack of immediately available detox beds, and program ineligibility for some patients due to medical conditions. The model using peers as first responders had a positive impact as their experiences with addiction enabled them to more successfully engage patients. The PNs were critical in addressing high needs for case management and referral and external partners were also important for implementation.Conclusions: Results underscore the effort needed to integrate this important model within EDs as part of a multi-level approach to address opioid misuse. The identified challenges led to statewide strategic planning and areas for further development. OORP is a promising intervention that might increase the number of individuals suffering with opioid disorders linked to peer support, treatment and recovery.