Prisoner Overdose Training and Naloxone Upon Release

说明（由申请人提供）：在全国范围内，药物中毒（过量）是成年人意外死亡的第二大原因，也是罗德岛州和其他15个州成年人意外死亡的主要原因。离开监狱或拘留所的人因过量服用药物而死亡的风险很高，特别是在释放后的头两周。本研究旨在通过针对监狱环境的预防干预来直接解决这一问题。具体目标是：1)制作一个过量预防和纳洛酮管理培训数字视频光盘（DVD），供囚犯出狱前使用；2)评估对离开教养设施的囚犯进行阿片类药物过量预防和纳洛酮管理教育DVD干预的可行性和可接受性；3)评估参与者在接受干预三个月后对阿片类药物过量预防/纳洛酮给药行为的知识保留、信心和演示。目标人群是那些即将从罗德岛监狱释放的囚犯，他们自己或者认识吸毒的人。为了实现具体目标，将根据既定的培训规程和为监狱环境量身定制的教学培训，制定DVD干预措施。来自前囚犯、培训人员、监狱工作人员和国家过量预防专家的反馈将为DVD的发展提供信息。在为期12个月的实地测试中，125名参与者将参加利用DVD和教学内容的小组培训。成功完成培训的参与者在出狱后将获得纳洛酮。随访评估干预措施的保留和可接受性将在出狱后3个月在社区研究地点进行。本研究结果将为未来的随机对照试验研究提供先导数据。结果还将通过在监禁环境中实施以及通过评估关键阿片类药物过量预防和纳洛酮给药知识的保留情况、信心和尚未正式评估的技能展示来扩大领域。

DESCRIPTION (provided by applicant): Nationally, drug poisonings (overdoses) are the second leading cause of accidental death among adults and the leading cause of adult accidental death in Rhode Island and in 15 other states. Individuals leaving prison or jail are at high risk for death from overdose, especially during the first two weeks after release. This study seeks to directly address this problem through a prevention intervention tailored to the prison setting. Specific aims are to: 1) create an overdose prevention and naloxone administration training Digital Video Disc (DVD) for use with prisoners prior to their release from incarceration; 2) assess the feasibility and acceptability of an opiate overdose prevention and naloxone administration educational DVD based intervention for inmates leaving a correctional facility; and 3)assess participants' retention of knowledge, confidence, and demonstration of critical opiate overdose prevention/naloxone administration behaviors three months after receiving the intervention. The targeted population is inmates who are within four weeks of release from the Rhode Island Department of Corrections who are themselves or know people who are involved in drug use. To accomplish the specific aims, a DVD intervention will be developed based on established training protocols and the didactic training tailored for delivery in a prison setting. Feedback from former prisoners, trainers, prison staff, and national experts in overdose prevention will inform the DVD development. In a field test conducted over a 12-month period, 125 participants will take part in a group format training that utilizes DVD and didactic components. Participants who successfully complete the training will receive naloxone when released from incarceration. Follow-up to assess retention and acceptability of the intervention will occur 3 months post release from incarceration at a community-located study site. Findings from this study will provide pilot data for a future randomized controlled trial study. Results will also expand the field both by its implementation in an incarcerated setting and by evaluating retention of key opiate overdose prevention and naloxone administration knowledge, confidence, and demonstration of skills that have not been formally assessed. PUBLIC HEALTH RELEVANCE: With injection drug use and other opiate use leading to a substantial increase in overdose mortality in the United States, and a substantial proportion of that traditionally hard-to-reach population passing through correctional facilities each year, there exists a tremendous opportunity to provide critical education information regarding overdose prevention in the incarcerated setting. This application aims to evaluate a naloxone education intervention among prison inmates at the Rhode Island Department of Corrections (RIDOC). Data generated through this pilot study will be instrumental for developing larger scale intervention trials which will assess effectiveness of a naloxone intervention upon release from incarceration.