Disruptions to Naloxone Training Among Lay and Occupational Responders in Maryland During the Emergence of COVID-19: Early Impacts, Recovery, and Lessons Learned

Overview

Journal Drug Alcohol Depend Rep

Specialty Psychiatry

Date 2023 Jun 26

PMID 37362079

Authors

Himani Byregowda

Catherine Tomko

Kristin E Schneider

Erin Russell

Renee M Johnson

Ryoko Susukida

Saba Rouhani

Taylor Parnham

Ju Nyeong Park

Affiliations

Soon will be listed here.

Abstract

Background: : Opioid overdose death rates increased during the COVID-19 pandemic. Disruptions in community-based naloxone trainings could have reduced the likelihood of overdose reversal and increased the chances of a fatal overdose. We investigated changes in the number of people trained in naloxone administration and distribution in Maryland before, during, and after COVID-related stay-at-home orders.

Methods: : Data on naloxone training are from the Maryland Department of Health. We used interrupted time series models to estimate changes in average monthly number of people trained: [1] pre-interruption (4/2019-3/2020), [2] 1-month post-interruption (4/2020-5/2020), and [3] 12-months post-interruption (4/2020-3/2021). Trainees were classified as lay (e.g., people who use drugs) or occupational (e.g., law enforcement officers and harm reduction workers) responders.

Results: : There were 101,332 trainees; 54.1% lay, 21.5% occupational, and 23.4% unknown responder status. We observed a decrease in the average monthly number of trainees in the pre-interruption period (-235, <0.001), a larger decrease of 93.2% during the 1-month post-interruption (-846, =0.013), and an increase 12-months post-interruption (+217, <0.001). There was a significant decrease among occupational responders 1-month post-interruption, and a significant increase among lay responders in the 12-month post-interruption period.

Conclusions: : Findings suggest a marked decrease in naloxone trainees immediately after stay-at-home order, followed by a moderate rebound in the 12-months after stay-at-home order. The decrease in occupational responders trained may have limited access to naloxone, but would likely have been offset by increases in number of lay responders trained. Strengthening lay and occupational responder connections could maintain naloxone distribution during public health crises.

Citing Articles

Neighborhood and Individual Disparities in Community-Based Naloxone Access for Opioid Overdose Prevention.

Nesoff E, Meisel Z, Saeed H, Martins S J Urban Health. 2024; 101(1):64-74.

PMID: 38196059 PMC: 10897088. DOI: 10.1007/s11524-023-00821-z.

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