Naloxone

To reverse an overdose and prevent death, naloxone must be administered as soon as possible to a person experiencing an active opioid overdose. OEND programs are most successful in settings where staff are available to employ the program in settings where many people who use drugs may pass through.

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

Naloxone must be administered as soon as possible to an individual experiencing an active opioid overdose to reverse the overdose and prevent death. OEND programs seek to address the key factors that facilitate effective use of naloxone: 

  1. Ensure individuals have naloxone when they need it (i.e. when experiencing an opioid overdose)
  2. Educate individuals on how to recognize an overdose and use the naloxone delivery service
  3. Encourage individuals to use naloxone when needed

OEND programs play an important role in any larger treatment strategy for substance use disorder, which can also include counseling and medications for opioid use disorder (e.g., buprenorphine, methadone, or naltrexone). Successful OEND programs tend to have staff that can incorporate opioid overdose education and naloxone dispensing into their typical workflow and where many people who could potentially benefit from naloxone pass through, such as prisons or emergency departments.