Online Training on Opioid Overdose Prevention, Recognition, and Response

描述(由申请者提供)：我们建议将纽约州使用的成功、有效、CASAC批准的过量用药预防、识别和反应培训课程(S.K.O.P.-过量预防技能和知识)转换为在线计算机辅助教学(CAI)格式，以显著影响这一救命的、以社区为基础的课程在全国范围内的传播。致命的药物过量，包括合法和非法药物，在美国急剧增加。药物过量现在是美国意外死亡的第二大原因，也是35-54岁的人意外死亡的首要原因。根据美国疾病控制与预防中心的数据，2006年，有22,400人死于意外服药过量，这是可获得数据的最新年份。其中大多数与阿片类药物有关。越来越多的阿片类药物相关过量与处方阿片类药物有关。虽然所有药物类别的过量使用都在增加，但与阿片类药物相关的死亡尤其悲惨，因为它们基本上是可以预防的。存在一种安全、廉价、易于管理的解毒剂--盐酸纳洛酮或纳尔康。对于那些对注射器感到不适的人，这种解毒剂可以由家人或同龄人在注射器中或通过黏膜雾化装置(鼻腔喷雾)给予。纳洛酮可以恢复因过量服药而受到抑制的呼吸频率。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。由于85%的过量用药是在他人的陪伴下发生的，因此存在使用纳洛酮进行干预的机会之窗(或者在没有纳洛酮的情况下进行抢救呼吸)。然而，许多阿片类药物过量，特别是涉及处方药的药物，在过量服药过程中可能与过量受害者有接触的家人或朋友并不承认这一点。其他人试图干预，但他们的努力往往无效。直到最近，成功的干预还需要获得护理人员的帮助，以使服药过量的受害者苏醒。然而，医护人员往往来得太晚，对逮捕的恐惧意味着他们通常不会被旁观者叫来协助。这种太常见的情况导致了创新的、以社区为基础的预防教育和干预计划的发展，比如纽约的S.K.O.P.计划，该计划目前在纽约市和州培训医疗提供者、培训者和社区成员。培训包括预防、识别和应对(拨打911，进行抢救呼吸，并在可用时使用纳洛酮)。仅在纽约市，每年就有600人死于过量用药，S.K.O.P.已经培训了5000人，并被认为有350例报告的过量用药逆转，没有报告不良反应。在线访问的该计划的计算机辅助版本将在全国范围内接触到比面对面培训更多的个人，这将是非常宝贵的。它还将为已经接受过面对面培训的应答者提供服务，以回顾他们所学到的知识。(纽约州要求响应者每两年完成一次进修培训。)它将能够培训更多的培训员，并将向医疗和其他专业人员提供有关拯救生命的最新信息。 公共卫生相关性：该项目承诺通过将一个成功的、有效的、经CASAC批准的过量用药预防、识别和反应培训课程(S.K.O.O.P.--过量用药预防的技能和知识)转化为在线计算机辅助教学(CAI)格式，从而极大地促进公共健康。过量的训练将严重影响这种救命的、以社区为基础的课程在全国范围内的传播。

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.