Online Training on Opioid Overdose Prevention, Recognition, and Response

描述（由申请人提供）：我们建议将在纽约州使用的成功、有效、经CASAC批准的过量预防、识别和反应培训课程（S.K.O.O. P-过量预防技能和知识）转化为在线计算机辅助教学（CAI）格式，以显著影响该拯救生命、基于社区的课程在全国范围内的传播。在美国，来自法律的和非法药物的致命药物过量急剧增加。药物过量现在是美国意外死亡的第二大原因，也是35-54奥尔兹意外死亡的主要原因。根据疾病预防控制中心的数据，2006年有22,400人死于意外过量，这是有数据可查的最新一年。其中大多数与类阿片有关。与类阿片有关的药物过量越来越多地与处方类阿片有关。虽然所有药物类别的过量都在增加，但与类阿片有关的死亡特别悲惨，因为它们在很大程度上是可以预防的。存在一种安全、廉价、易于管理的解毒剂-盐酸纳洛酮或纳洛酮。这种解毒剂可以由家庭成员或同龄人在注射器中或通过粘膜雾化器装置（鼻喷雾器）给那些对注射器不舒服的人服用。纳洛酮恢复了因过量而降低的呼吸速率。它没有精神活性;不是一种受管制的药物，几十年来一直被护理人员使用，没有不良反应。因为85%的过量用药发生在他人的陪伴下，所以存在纳洛酮干预的机会窗口（或当纳洛酮不可用时进行呼吸救援）。然而，许多阿片类药物过量，特别是涉及处方药的药物，在过量过程中可能与过量受害者接触的家人或朋友并没有认识到这一点。其他人试图干预，但他们的努力往往无效。直到最近，成功的干预措施需要获得护理人员来唤醒过量的受害者。然而，护理人员往往来得太晚，害怕被捕意味着他们往往不会被旁观者叫去协助。这种太普遍的情况导致了创新的、以社区为基础的预防教育和干预方案的发展，如纽约的S. K. O. O. P.方案，该方案目前在纽约市和纽约州培训医疗提供者、培训人员和社区成员。培训包括过量预防，识别和反应（拨打911，进行人工呼吸，并在可用时给予纳洛酮）。仅在纽约市，每年就有600人因过量用药死亡，S. K. O. O. P.已经培训了5000人，并被认为有350起报告的过量用药逆转，没有报告的不良反应。这个程序的CAI版本，在线访问，将是非常宝贵的，在达到更多的个人比面对面的培训，全国范围内。它还将为已经接受过面对面培训的应急人员提供服务，以审查他们所学到的知识。(NY要求响应者每两年完成一次复习培训。这将有助于培训更多的培训人员，并将向医务和其他专业人员提供关于拯救生命的最新信息。 公共卫生相关性：该项目承诺通过翻译一个成功的，有效的，CASAC批准的过量预防，识别和反应培训课程（S. K. O. O. P. -过量预防的技能和知识）转化为在线计算机辅助教学（CAI）格式。过量用药培训将对这一拯救生命、以社区为基础的课程在全国范围内的传播产生重大影响。

DESCRIPTION (provided by applicant): We propose to translate a successful, efficacious, CASAC-approved overdose prevention, recognition and response training curriculum (S.K.O.O.P-Skills and Knowledge on Overdose Prevention) utilized in NY State into an online Computer-Assisted Instructional (CAI) format to significantly impact the dissemination of this life- saving, community-based curriculum, nation-wide. Fatal drug overdoses, from both legal and illegal drugs, have increased dramatically in the U.S. Drug overdose is now the second leading cause of accidental death in the U.S. and the leading cause of accidental death among 35-54 year olds. According to the CDC, 22,400 individuals died following an accidental overdose in 2006, the latest year for which data are available. A majority of these were opioid-related. Increasingly, opioid-related overdoses have been associated with prescription opiates. While overdoses are increasing in all drug categories, opioid-related deaths are especially tragic because they are largely preventable. A safe, cheap, easy to administer antidote exists- naloxone hydrochloride or Narcan". This antidote can be administered by family members or peers in a syringe or via a mucosal atomizer device (nasal spray) for those who are uncomfortable with syringes. Naloxone restores respiration rates which have been depressed by the overdose. It has no psychoactive properties; is not a controlled drug and has been utilized without adverse effects for decades by paramedics. Because 85 percent of overdoses occur in the company of others, a window of opportunity exists for intervention with naloxone (or rescue breathing when naloxone is not available). However, many opioid overdoses, especially those involving prescription medications, are not recognized as such by family or friends who may have contact with the overdose victim during the course of the overdose. Others try to intervene, but their efforts are often ineffective. Until recently, successful interventions required access to paramedics to revive the overdose victim. However, paramedics often arrive too late and fear of arrest means they are often not called by bystanders to assist. This all too common scenario has led to the development of innovative, community-based prevention education and intervention programs like New York's S.K.O.O.P. program which currently trains medical providers, trainers, and community members in NYC and State. Training includes overdose prevention, recognition and response (Call 911, perform rescue breathing and, when available, administer naloxone). In just NYC alone, where overdose deaths total 600 per year, S.K.O.O.P. has trained 5000 individuals and been credited with 350 reported overdose reversals with no reported adverse effects. A CAI version of this program, accessed online, will be invaluable in reaching many more individuals than is possible with face-to-face trainings, nationwide. It will also serve responders who have already undergone face-to-face training to review what they have learned. (NY requires that responders complete a refresher training every two years.) It will enable the training of more trainers, and will provide medical and other professionals with up-to-date information on saving lives. PUBLIC HEALTH RELEVANCE: This project promises to contribute greatly to public health by translating a successful, efficacious, CASAC-approved overdose prevention, recognition and response training curriculum (S.K.O.O.P.- Skills and Knowledge on Overdose Prevention) into an online Computer-Assisted Instructional (CAI) format. The overdose training will significantly impact the nationwide dissemination of this life-saving, community-based curriculum.