Impact of overdose prevention education and intranasal naloxone on fatal and non-

描述（由申请人提供）： 项目总结/摘要 拟定目标：作为对国家资助的过量教育和纳洛酮分布（OEND）计划的评价，本研究提案，INPEDE OD-鼻内纳洛酮和预防教育对过量的影响-研究，响应了NCIPC/CDC RFA-CE-09 - 004的两个研究目标：成人处方药过量的意外中毒。首先，本研究将评价一项向药物过量高风险人群提供纳洛酮作为解毒剂的计划（研究目标5）。第二，它是研究，可以通过二级数据分析，在一个国家，将评估一个国家的新的过量预防计划的健康影响（研究目标#7）通知正在进行的政策辩论处方药过量预防。重要性：这项研究的结果将有助于公共卫生机构和社区组织的科学基础，他们正在寻求新的方法来解决药物过量引起的意外中毒。由于该研究是与马萨诸塞州公共卫生部（MDPH）合作进行的，并评估了MDPH支持的OEND计划，因此该研究将对该计划在马萨诸塞州的实施产生直接和直接的影响。研究目的：具体目标：确定阿片类药物过量教育与鼻内纳洛酮分配（OEND）计划对致死性和非致死性阿片类药物过量率的影响。假设：1.在致死性阿片类药物过量负担高的马萨诸塞州社区中，2006年至2009年实施的OEND计划与致死性阿片类药物过量率的下降有关。2.在非致命性阿片类药物过量负担高的马萨诸塞州社区中，2006年至2009年实施的OEND计划与非致命性阿片类药物过量率的下降有关。研究设计：准实验中断时间序列比较。地点：马萨诸塞州参与者：马萨诸塞州的18个社区，每年发生5起或更多致命阿片类药物过量事件。干预措施：马萨诸塞州的OEND计划，包括在潜在的过量旁观者中分配鼻内纳洛酮，包括针头交换参与者、艾滋病毒/艾滋病教育和预防计划的客户、药物滥用治疗计划的客户、过量高危人群的朋友和家人以及在药物滥用治疗和社会服务组织工作的专业人员。结果测量：阿片类药物过量高负担的马萨诸塞州社区每年致死性和非致死性阿片类药物过量率的变化。 公共卫生相关性： 阿片类药物过量预防的一种新方法是纳洛酮分配（OEND）计划的过量教育。在18个阿片类药物过量的马萨诸塞州社区中，拟议的INPEDE OD-鼻内纳洛酮和预防教育对过量的影响-研究将使用中断的时间序列分析来确定OEND计划的影响，以检查每年死亡和非死亡的变化，2002年至2009年期间，与未实施OEND计划的社区相比，实施OEND计划的社区的致命过量率。这项研究的结果将直接关系到全国公共卫生实体减少过量的努力。

DESCRIPTION (provided by applicant): Project Summary/ Abstract Proposed Objective: As an evaluation of a state-sponsored overdose education and naloxone distribution (OEND) program, this research proposal, the INPEDE OD - Intranasal Naloxone and Prevention EDucation's Effect on OverDose - Study, responds to two research objectives of NCIPC/CDC RFA-CE-09-004: Unintentional poisoning from prescription drug overdoses in adults. First, the study will evaluate a program that provides naloxone as an antidote to persons at high risk for overdose (Research Objective #5). Second, it is research that can inform the ongoing policy debate on prescription drug overdose prevention through secondary data analysis in a state that will assess the health impact of a state's new overdose prevention program (Research Objective #7). Importance: Findings from this study will contribute to the scientific base for public health agencies and community organizations who are seeking novel approaches to address unintentional poisonings from drug overdose. Because the study is conducted in partnership with the Massachusetts Department of Public Health (MDPH) and it evaluates an MDPH-supported OEND program, this study will have direct and immediate impact on the implementation of this program in Massachusetts. Study Objectives: Specific Aim: Determine the impact of opioid overdose education with intranasal naloxone distribution (OEND) programs on fatal and non-fatal opioid overdose rates. Hypotheses: 1. Among Massachusetts communities with high burdens of fatal opioid overdose, the implementation of OEND programs from 2006 to 2009 is associated with decreased rates of fatal opioid overdose. 2. Among Massachusetts communities with high burdens of non-fatal opioid overdose, the implementation of OEND programs from 2006 to 2009 is associated with decreased rates of non-fatal opioid overdose. Study Design: Quasi-experimental interrupted time series comparison. Setting: Commonwealth of Massachusetts Participants: 18 communities in Massachusetts with 5 or more fatal opioid overdoses annually. Intervention: Massachusetts OEND program that includes distribution of intranasal naloxone among potential overdose bystanders, including needle exchange participants, clients of HIV/AIDS education and prevention programs, clients of substance abuse treatment programs, friends and family of people at high risk for overdose, and professionals working in substance abuse treatment and social services organizations. Outcome Measures: Change in annual fatal and non-fatal opioid overdose rates in communities in the Commonwealth of Massachusetts with high burden of opioid overdose. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE One novel approach to opioid overdose prevention is overdose education with naloxone distribution (OEND) programs. Among 18 Massachusetts communities with high numbers of opioid overdoses, the proposed INPEDE OD - Intranasal Naloxone and Prevention EDucation's Effect on OverDose - Study will determine the impact of OEND programs using an interrupted time series analysis to examine changes in annual fatal and non-fatal overdose rates over the period from 2002 and 2009 in those communities where an OEND program was implemented compared to those communities where it was not. The results of this study will be directly relevant to the overdose reduction efforts of public health entities nationwide.