Effectiveness of take ACTION online naloxone training for law enforcement officers

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Abstract

Background

Training law enforcement officers (LEOs) to administer naloxone is a recommended strategy to reduce overdose deaths in the United States. To achieve this, an evidence-based and scalable naloxone training curriculum that is easy to use and readily scalable is needed. Convenient web-based training is a flexible method for delivering educational interventions particularly for LEOs who have irregular or shifting schedules. This study examined the effectiveness of a comprehensive web-based naloxone training that was created in partnership with LEOs on their knowledge, confidence, and attitudes regarding naloxone.

Methods

From May 2019 to September 2020, five law enforcement departments from Michigan participated in web-based naloxone training. A total of 182 LEOs (77% male) were in the final sample based on matching pre-and post-test surveys. LEOs were assessed on knowledge, confidence, and attitudes towards naloxone. Negative binomial and Poisson regression was conducted to assess associations between knowledge, confidence, and attitudes towards naloxone before and after training.

Results

Significant improvements in overdose knowledge and confidence were revealed across all departments with median (IQR) total composite scores for knowledge increasing from 35 (32, 37) to 40 (39, 42) (p < 0.01) and confidence increasing from 18.5 (15, 20) to 20 (20, 25) (p < 0.01). Median (IQR) attitude scores did not change.

Conclusion

Our web-based naloxone training was effective in improving knowledge and confidence for LEOs but did not significantly improve LEOs attitudes towards naloxone across most departments. The web-based format is readily scalable and quickly disseminated and meets the immediate need for LEO overdose training. Additional intervention is needed to address the negative attitudes of LEOs regarding naloxone.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40352-023-00250-9.

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Most cited references 49

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Why are some people who have received overdose education and naloxone reticent to call Emergency Medical Services in the event of overdose?

Ingrid Binswanger, Shane R Mueller, Lisa Raville … (2017)

Overdose Education and Naloxone Distribution (OEND) training for persons who inject drugs (PWID) underlines the importance of summoning emergency medical services (EMS). To encourage PWID to do so, Colorado enacted a Good Samaritan law providing limited immunity from prosecution for possession of a controlled substance and/or drug paraphernalia to the overdose victim and the witnesses who in good faith provide emergency assistance. This paper examines the law's influence by describing OEND trained PWIDs' experience reversing overdoses and their decision about calling for EMS support.

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“Caught with a body” yet protected by law? Calling 911 for opioid overdose in the context of the Good Samaritan Law

Amanda D Latimore, Rachel Bergstein (2017)

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Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal.

Phillip O Coffin, Sean D Sullivan (2013)

Opioid overdose is a leading cause of accidental death in the United States. To estimate the cost-effectiveness of distributing naloxone, an opioid antagonist, to heroin users for use at witnessed overdoses. Integrated Markov and decision analytic model using deterministic and probabilistic analyses and incorporating recurrent overdoses and a secondary analysis assuming heroin users are a net cost to society. Published literature calibrated to epidemiologic data. Hypothetical 21-year-old novice U.S. heroin user and more experienced users with scenario analyses. Lifetime. Societal. Naloxone distribution for lay administration. Overdose deaths prevented and incremental cost-effectiveness ratio (ICER). In the probabilistic analysis, 6% of overdose deaths were prevented with naloxone distribution; 1 death was prevented for every 227 naloxone kits distributed (95% CI, 71 to 716). Naloxone distribution increased costs by $53 (CI, $3 to $156) and quality-adjusted life-years by 0.119 (CI, 0.017 to 0.378) for an ICER of $438 (CI, $48 to $1706). Naloxone distribution was cost-effective in all deterministic and probabilistic sensitivity and scenario analyses, and it was cost-saving if it resulted in fewer overdoses or emergency medical service activations. In a "worst-case scenario" where overdose was rarely witnessed and naloxone was rarely used, minimally effective, and expensive, the ICER was $14 000. If national drug-related expenditures were applied to heroin users, the ICER was $2429. Limited sources of controlled data resulted in wide CIs. Naloxone distribution to heroin users is likely to reduce overdose deaths and is cost-effective, even under markedly conservative assumptions. National Institute of Allergy and Infectious Diseases.

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Author and article information

Contributors

Chin Hwa Dahlem:

ORCID: http://orcid.org/0000-0001-7598-0427

ginayi@med.umich.edu

Journal

Journal ID (nlm-ta): Health Justice

Journal ID (iso-abbrev): Health Justice

Title: Health & Justice

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Electronic): 2194-7899

Publication date (Electronic): 18 November 2023

Publication date PMC-release: 18 November 2023

Publication date Collection: December 2023

Volume: 11

Electronic Location Identifier: 47

Affiliations

[1 ]Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, ( https://ror.org/00jmfr291) 400 N. Ingalls Rd Rm 3174, Ann Arbor, MI 48109 USA

[2 ]Applied Biostatistics Laboratory, Ann Arbor, USA

[3 ]Department of System Populations and Leadership, Ann Arbor, USA

[4 ]Institute for Healthcare Policy and Innovation, University of Michigan, ( https://ror.org/00jmfr291) Ann Arbor, USA

Author information

Chin Hwa Dahlem http://orcid.org/0000-0001-7598-0427

Article

Publisher ID: 250

DOI: 10.1186/s40352-023-00250-9

PMC ID: 10656891

PubMed ID: 37979100

SO-VID: 215412be-f171-47c4-a54a-137cfe35c0fa

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 22 May 2023

Date accepted : 9 November 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100000058, Substance Abuse and Mental Health Services Administration;

Award ID: SOR+ E20203204-00

Award Recipient : Chin Hwa Dahlem

Custom metadata

Keywords: law enforcement,naloxone,overdose,police,online,attitudes,knowledge

Data availability:

Keywords: law enforcement, naloxone, overdose, police, online, attitudes, knowledge

Effectiveness of take ACTION online naloxone training for law enforcement officers

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Most cited references 49

Why are some people who have received overdose education and naloxone reticent to call Emergency Medical Services in the event of overdose?

“Caught with a body” yet protected by law? Calling 911 for opioid overdose in the context of the Good Samaritan Law

Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal.

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