Module 2: Overdose Prevention Strategies Without Naloxone
There are important ways you can integrate overdose prevention into your current work at little to no cost. Although all of these suggestions may not be relevant to your unique program structure, they are a great starting point to begin brainstorming ways that overdose prevention can fit into your program.
The next section offers guidance for implementing some of these suggestions.
Implementing Low-Cost Overdose Prevention Strategies
- Put up posters about preventing or responding to an overdose
- Provide educational materials (brochures, fact sheets) for program participants on overdose
- Develop a policy for responding to on-site overdose
- Train program staff and volunteers on overdose — including risk factors, signs and symptoms, and response (including rescue breathing and naloxone administration)
- Discuss overdose risks with participants and screen participants for higher risk
- Ask program participants if they have witnessed an overdose
- Ask program participants if they have survived an overdose
- Talk to program participants about the availability of naloxone
- Offer referrals to places where program participants can get naloxone
- Talk with program participants about what to do if they’re with someone who is overdosing
- Discuss or incorporate overdose prevention in groups
Integrate Overdose Prevention Messages as Standard Practice
There are several practical, participant-centered strategies that can be employed to assist staff in promoting overdose prevention messaging. Overdose prevention messages are relevant to anyone who uses drugs, whether they use prescription drugs or “street drugs.” These messages can easily be incorporated into various settings, including primary health care, mental health services, drug treatment programs, shelters, supportive housing or correctional settings.
For example, staff can engage participants around overdose risk during informal conversations by asking if they plan to use alone or if they have friends that they know they use. For participants who have recently been released from jail or come out of drug treatment, a conversation reminding them about the increased risk of overdose can be lifesaving.
More formally, staff can add questions about overdose risk to intake/assessment forms, health screenings or include overdose risk reduction as an integral component of treatment planning.
Posting overdose messages on fliers or posters in the agency provides another way of engaging program participants around overdose and sends the message that staff is available to discuss overdose risk and response. The only costs associated with any of these strategies are staff time for training and printing costs of any materials posted in the agencies.
Develop an Onsite Overdose Response Policy
A simple strategy for integrating overdose prevention into your program is to develop a policy for responding to on-site overdose. Having such a policy in place is not only vitala in the event of an overdose, but it has the additional benefits of getting agency staff or volunteers engaged in overdose prevention issues and sends a message to program participants that their lives and safety are valued. This strategy does not require a great deal of resources. The main cost involved in developing a policy is staff time for those involved in the policy development, as well as the time needed to train all staff on the emergency response plan once it is in place.
In order to develop an overdose response plan for your agency, it is important to assess current circumstances related to overdose. See the interactive resource “Develop an Overdose Response Plan” below.
These considerations are important to take into account when drafting an overdose response policy that is tailored to your agency. Some agencies may opt to incorporate naloxone training into their protocol, others may rely on calling 911 and doing rescue breathing, while others may train staff to take all these measures.
Provide Overdose Response Training for Participants
Overdose prevention and response education and training can be developed for program participants even if a program is not yet equipped to distribute naloxone. Some of the earliest overdose prevention efforts, such as distributing written materials, posting educational fliers and running groups about overdose, were initiated long before naloxone became available.
Providing education about overdose risk, recognizing overdose, performing rescue breathing, and calling 911 can all be lifesaving interventions. These educational sessions can be incorporated into existing group schedules or done one-on-one with participants. Session length can vary from ten to sixty minutes depending on the setting and trainee experience.
Costs related to participant trainings vary depending on the different supplies you decide to incorporate into your workshop.
Basic costs for implementing overdose prevention training include:
- Staff time: For outreach and to conduct or staff the training.
- Development/Printing of Materials and Handouts: Educational materials can either be created in-house or there are numerous pamphlets and brochures available from other harm reduction organizations.
Optional costs may also include:
- Rescue breathing dummies (approximately $70): A great training tool for practicing rescue breathing.
- CPR mouth shields (approximately $180 for a box of 250): Great for both training and incentives.
Develop an Overdose Response Plan
- Has overdose already occurred in your agency? If so, how was it handled? What worked well and what needs improvement?
- Are there locations within the agency that may present heightened overdose risks or complicate overdose response (such as bathrooms that lock or private rooms in Single Resident Occupancy hotels)?
- Does your agency have outreach staff or volunteers who work with people off-site, in the street or home visits? What is the protocol if they witness an off-site overdose while working?
- Does an existing overdose response policy need to be evaluated or updated?
- Does your agency have staff on-site with medical and/or CPR training?