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Training family members to manage heroin overdose and administer naloxone: randomized trial of effects on knowledge and attitudes

2013; Wiley; Volume: 109; Issue: 2 Linguagem: Inglês

10.1111/add.12360

1360-0443

Anna Williams, John Marsden, John Strang,

Prenatal Substance Exposure Effects

Abstract Aims To evaluate a heroin overdose management training programme for family members based on emergency recovery procedures and take‐home naloxone ( THN ) administration. Design A two‐group, parallel‐arm, non‐blinded, randomized controlled trial of group‐based training versus an information‐only control. Setting Training events delivered in community addiction treatment services in three locations in E ngland. Participants A total of 187 family members and carers allocated to receive either THN training or basic information on opioid overdose management ( n = 95 and n = 92, respectively), with 123 participants completing the study. Measurements The primary outcome measure was a self‐completion O pioid O verdose K nowledge S cale ( OOKS ; range 0–45) and an O pioid O verdose A ttitudes S cale ( OOAS ; range 28–140) was the secondary outcome measure. Each group was assessed before receiving their assigned condition and followed‐up 3 months after. Events of witnessing and managing an overdose during follow‐up were also recorded. Findings At follow‐up, study participants who had received THN training reported greater overdose‐related knowledge relative to those receiving basic information only [ OOKS mean difference, 4.08 (95% confidence interval, 2.10–6.06; P < 0.001); C ohen's d = 0.74 (0.37–1.10)]. There were also more positive opioid overdose‐related attitudes among the trained group at follow‐up [ OOAS mean difference, 7.47 (3.13–11.82); P = 0.001; d = 0.61 (0.25–0.97)]. At the individual level 35 and 54%, respectively, of the experimental group increased their knowledge and attitudes compared with 11 and 30% of the control group. During follow‐up, 13 participants witnessed an overdose with naloxone administered on eight occasions: five among the THN ‐trained group and three among the controls. Conclusions Take‐home naloxone training for family members of heroin users increases opioid overdose‐related knowledge and competence and these benefits are well retained after 3 months.