Naloxone

OEND programs can further increase inequities in naloxone access and opioid overdose outcomes if they are established in areas or locations where a single homogenous community resides.

Evidence for the intervention

Evidence supporting opioid overdose education and naloxone distribution (OEND) programs is summarized in at least eight systematic reviews. These draw mostly from observational study designs, including case series, cohort studies, and quality improvement studies. There are very few randomized controlled trials evaluating OEND programs, largely due to the overwhelming body of real-world evidence supporting naloxone distribution; this is common for interventions with substantial face-value credibility, such as parachutes or epinephrine pens. The few existing randomized controlled trials of OEND programs tend to compare one OEND implementation strategy to another OEND implementation strategy

Evidence-based Scale

Like any healthcare resource, OEND programs can produce or further entrench health care disparities based on where OEND programs are established. Implementing an OEND program in a single homogenous community or hospital, for example, may improve naloxone access and opioid overdose survival among the community served by that hospital yet neglect the same outcomes in an adjacent community with individuals from different economic backgrounds, with different religious preference, or with different demographic characteristics. Thus, those seeking to implement an OEND program should carefully consider the target setting and population.