Filling Gaps in Overdose Reversal Trainings for People Who Use Drugs

In 2020, Assistant Scientist Kristin Schneider and Associate Professor Karin Tobin set out to determine whether overdose reversal programs adequately address the unique barriers people who use drugs face after reversing an overdose. Specifically, they explored:  

1. What made it easier or more difficult for people to acquire more naloxone after an initial training, and 
2. How providers of overdose reversal programs address barriers to naloxone refills.  

They wanted to use the lessons learned to create a toolkit on overdose reversal training curricula to better meet the needs of people who use drugs.  

The team conducted in-depth interviews with 20 people who use drugs about their knowledge of naloxone, experiences with overdose reversal training, barriers to obtaining naloxone refills, and recommendations for improving programming. They also completed in-depth interviews with providers of overdose reversal program trainings about training goals, supplies provided to training participants, policies for naloxone refills and perceived barriers to changing refill policies.  

The researchers found:  

• Most participants had minimal knowledge about naloxone availability in the community.  
• Many wrongly believed they needed to get a prescription to access more naloxone, even if they had been recently trained. 
• Cost is a barrier. Most were unwilling to spend more than $2-$3 for naloxone and were unaware that insurance may cover naloxone and reduce pharmacy costs.  
• Many programs that offered naloxone training did not provide information to clients about other sources of naloxone in the community.  

Based on these interviews, they found several ways to improve trainings in Baltimore: 

• Provide information about different sources of naloxone available in the community.  
• Explicitly inform participants that prescriptions are not required to access naloxone at a pharmacy in the city.  
• Inform clients that insurances, including Medicaid, will cover most pharmacy related naloxone costs. 
• Set expectations of post overdose reversal experiences and equip clients with conflict resolution strategies to respond to any negative responses.