Over 600 people die each year in New Mexico from opioid overdoses. Officials have called the current opioid epidemic the worst drug crisis in American history. Overdose is now the leading cause of death in the U.S. for people under 50.

Overdose prevention programs with Narcan

Overdose prevention programs are widely used with priority populations of opioid users and their families as a harm reduction strategy. Overdose prevention programs teach bystanders to recognize the signs of an opioid overdose, get help, and administer Narcan.

Narcan nasal spray

Narcan is an opioid antagonist medication that immediately reverses the opioid induced respiratory depression that leads to an overdose death. It cannot be abused and is harmless if given to a person who has not ingested opioids. Narcan is available without a prescription and without restriction to anyone in NM.

Overdose prevention program benefits

From 1996-2014, overdose prevention programs have provided 152,000 laypersons with Narcan kits and received reports of over 26,000 overdose reversals. Program evaluation has shown that overdose prevention programs with Narcan consistently reduced opioid overdose mortality and have a low rate of adverse events. Reviews of multiple programs show that 15-20% of those trained to use Narcan use it.

Studies have provided additional evidence that not only are these programs saving lives; they do not cause an increase in opioid use. There have also been notable unintended benefits from opioid users in overdose prevention programs, such as decreased drug use, increased HIV testing and participants training additional friends and family.

Design a Cohort Study

Traditionally, overdose first aid programs have been used with populations in Opioid Use Disorder (OUD) treatment and recovery. Narcan is a peer-led harm reduction strategy. Nobody can save themselves from an overdose, first aid must be given by a bystander. Therefore, family and community overdose first aid programs have been successful in preparing those who may witness an overdose independent of their own drug use status.

To study effectiveness on an overdose first aid program on teens with high exposure to opioid use in a juvenile detention center, a cohort study was funded by the State Opioid Response, a grant provided to NM by the federal government. The Bernalillo County Youth Services Center (YSC) is a pre-trial detention center in Albuquerque for youth 11-17. Average stay at YSC is 3 weeks, and the population has a high likelihood of returning to homes and communities with opioid use.

You are the epidemiologist who has been asked to design this study. Answer the questions below to help you design your study.

1. What would be the hypothesis of the study?

2. Baseline surveys were given to each participant asking the following questions:

• Do you know anyone who uses opioids?
• Have you seen anyone use opioids?
• Do you know anyone who has had an opioid overdose?
• Have you seen an opioid overdose?

- What would you select for your exposure measure based on these questions?

- How would you define the exposed group and the unexposed group?

3. What would be the outcomes of this cohort study?

4. How often would you follow-up the study participants?

5. What follow-up data would you collect? How would you collect the data?