Skip to main content

Advertisement

SpringerLink
Log in

Characteristics of an Overdose Prevention, Response, and Naloxone Distribution Program in Pittsburgh and Allegheny County, Pennsylvania

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Prevention Point Pittsburgh (PPP) is a public health advocacy organization that operates Allegheny County’s only needle exchange program. In 2002, PPP implemented an Overdose Prevention Program (OPP) in response to an increase in heroin-related and opioid-related overdose fatalities in the region. In 2005, the OPP augmented overdose prevention and response trainings to include naloxone training and prescription. The objective of our study is to describe the experiences of 426 individuals who participated in the OPP between July 1, 2005, and December 31, 2008. Of these, 89 individuals reported administering naloxone in response to an overdose in a total of 249 separate overdose episodes. Of these 249 overdose episodes in which naloxone was administered, participants reported 96% were reversed. The data support findings from a growing body of research on similar programs in other cities. Community-based OPPs that equip drug users with skills to identify and respond to an overdose and prescribe naloxone can help users and their peers prevent and reverse potentially fatal overdoses without significant adverse consequences.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. Because the OPP operates once a week, the earliest a participant can return for a refill is 7 days.

References

  1. Dasgupta N, Jonsson F, Brownstein JS. Comparing unintentional opioid poisoning mortality in metropolitan and non-metropolitan counties, United States 1999–2003. In: Thomas YE, Richardson D, Cheung I, eds. Geography and Drug Addiction. Netherlands: Springer; 2008: 175–192.

    Chapter  Google Scholar 

  2. Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999–2006. Hyattsville, MD: National Center for Health Statistics Data Brief No. 22; 2009.

    Google Scholar 

  3. Allegheny County of Pennsylvania Medical Examiner’s Office. Drug Overdose Deaths. 2000–2008. Annual Report.

  4. Galea S, Coffin PO. Drug overdose: new insights, innovative surveillance, and promising interventions. J Urban Health. 2003; 80: 186–188.

    Article  PubMed  Google Scholar 

  5. Sporer KA, Kral AH. Prescription naloxone: a novel approach to heroin overdose prevention. Ann Emerg Med. 2007; 49(2): 172–177.

    Article  PubMed  Google Scholar 

  6. Gaston RL, Best D, Manning V, Day E. Can we prevent drug related deaths by training opioid users to recognize and manage overdose? HRJ. 2009; 6(26): 1–8.

    Google Scholar 

  7. Heller D, Stancliff S. Providing naloxone to substance users for secondary administration to reduce overdose mortality in New York City. Public Health Rep. 2007; 122: 393–397.

    PubMed  Google Scholar 

  8. Galea S, Worthington N, Piper TM, Nandi V, Curtis M, Rosenthal DM. Provision of naloxone to injection drug users as an overdose prevention strategy: early evidence from a pilot study in New York City. Addict Behav. 2006; 31(5): 907–912.

    Article  PubMed  Google Scholar 

  9. Maxwell S, Bigg D, Stanczykiewicz K, Carlberg-Racich S. Prescribing naloxone to actively injecting heroin users: a program to reduce heroin overdose deaths. J Addict Dis. 2006; 25: 89–86.

    Article  PubMed  Google Scholar 

  10. Tracy M, Piper TM, Ompad D, et al. Circumstances of witnessed drug overdose in New York City: implications for intervention. Drug Alcohol Depend. 2005; 79(2): 181–190.

    Article  PubMed  Google Scholar 

  11. Sherman S, Gann DS, Scott G, Carlberg S, Bigg D, Heimer R. A qualitative study of overdose responses among Chicago’s IDUs. HRJ. 2008; 5(2): 1–5.

    Google Scholar 

  12. Darke S, Zador D. Fatal heroin ‘overdose’: a review. Addiction. 1996; 91(12): 1765–1772.

    Article  PubMed  CAS  Google Scholar 

  13. Darke S, Hall W. Heroin overdose: research and evidence-based intervention. J Urban Health. 2003; 80(2): 189–200.

    Article  PubMed  Google Scholar 

  14. Darke S, Hall W. The distribution of naloxone to heroin users. Addiction. 1997; 92: 1195–1199.

    Article  PubMed  CAS  Google Scholar 

  15. Piper TM, Stancliff S, Rudenstine S, et al. Evaluation of a naloxone distribution program in New York City. Subst Use Misuse. 2008; 43: 858–870.

    Article  PubMed  Google Scholar 

  16. Green T, Heimer R, Grau LE. Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States. Addiction. 2008; 103(6): 979–989.

    Article  PubMed  Google Scholar 

  17. Seal KH, Downing M, Kral AH, et al. Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: a survey of street-recruited injectors in the San Francisco Bay Area. J Urban Health. 2003; 80(2): 291–301.

    Article  PubMed  Google Scholar 

  18. Tobin KE, Davey MA, Latkin CA. Calling emergency medical services during drug overdose: an examination of individual, social and setting correlates. Addiction. 2005; 100(3): 397–404.

    Article  PubMed  Google Scholar 

  19. Pollini RA, McCall L, Mehta S, et al. Response to overdose among injection drug users. Am J Prev Med. 2006; 31(3): 261–264.

    Article  PubMed  Google Scholar 

  20. Enteen L, Bauer J, McLean R, et al. Overdose prevention and naloxone prescription for opioid users in San Francisco. J Urban Health. 2010; 87(6): 931–941.

    Article  PubMed  Google Scholar 

  21. U.S. Census Bureau. Census 2000; 2006 Population Estimate. Washington, DC: US Census Bureau; 2010. http://quickfacts.census.gov/qfd/states/42/4261000.html. Accessed June 27, 2010.

  22. Giblin P. Effective utilization and evaluation of indigenous health care workers. Public Health Rep. 1989; 104(4): 361–368.

    PubMed  CAS  Google Scholar 

  23. Snead J, Downing M, Lorvick J. Secondary syringe exchange among injection drug users. J Urban Health. 2003; 80(2): 330–348.

    Article  PubMed  Google Scholar 

  24. Cohen K. The Boundaries of Blackness: AIDS and the Breakdown of Black Politics. Chicago, IL: University of Chicago Press; 1999.

    Google Scholar 

  25. Braine N, Acker C, Goldblatt C, Yi H, Friedman S, DesJarlais DC. Neighborhood history as a factor shaping syringe distribution networks among drug users at a U.S. syringe exchange. Soc Networks. 2008; 30: 235–246.

    Article  PubMed  Google Scholar 

  26. Dasgupta N, Sanford CK, Albert S, Brason FW. Opioid drug overdoses: a prescription for harm and potential for prevention. Am J Lifestyle Med. 2010; 4: 32–37.

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Nabarun Dasgupta of the University of North Carolina and Project Lazarus for providing detailed comments on earlier drafts of this manuscript. We would also like to thank the many volunteers and participants involved in PPP’s OPP. Partial funding for Dr. Bennett was provided by the Behavioral Sciences Training in Drug Abuse Research Program sponsored by the Public Health Solutions of New York City and the National Development and Research Institutes, Inc. (NDRI), with funding from the National Institute on Drug Abuse (T32 DA07233).

Author information

Authors and Affiliations

  1. National Development and Research Institutes Inc., Public Health Solutions, New York, NY, USA

    Alex S. Bennett

  2. Prevention Point Pittsburgh, Pittsburgh, PA, USA

    Alex S. Bennett, Alice Bell, Laura Tomedi & Eric G. Hulsey

  3. School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Laura Tomedi

  4. RTI International, San Francisco, CA, USA

    Alex H. Kral

  5. University of California, San Fransisco, San Francisco, CA, USA

    Alex H. Kral

Authors
  1. Alex S. Bennett
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alice Bell
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Tomedi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eric G. Hulsey
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alex H. Kral
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alex S. Bennett.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bennett, A.S., Bell, A., Tomedi, L. et al. Characteristics of an Overdose Prevention, Response, and Naloxone Distribution Program in Pittsburgh and Allegheny County, Pennsylvania. J Urban Health 88, 1020–1030 (2011). https://doi.org/10.1007/s11524-011-9600-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-011-9600-7

Keywords

Search

Navigation