https://www.sciencedirect.com/science/article/pii/S0091743519302890?via%3Dihub

Comment; Post-overdose care should include drug use disorder help as it is the time frame most likely to be effective in getting a user who nearly died to re-assess their life and what they want from it. This is vulnerable time for users; it should not be wasted, this article provides a good review of what type of programs are being implemented.

Author links open overlay panelSarah M.BagleyabcSamantha F.SchoenbergeraKatherine M.WayeaAlexander Y.WalleyacShow morehttps://doi.org/10.1016/j.ypmed.2019.105813Get rights and content

Highlights

Nonfatal opioid overdose provides an opportunity to optimize safety.•

Locally developed post-overdose models have emerged to address overdose deaths.•

Evaluations of the effectiveness of these models are needed.•

Future work should focus on determining the best practices for post-overdose care.

Abstract

Introduction

Nonfatal opioid overdose is a significant risk factor for subsequent fatal overdose. The time after a nonfatal overdose may provide a critical engagement opportunity to both reduce subsequent overdose risk and link individuals to treatment. Post-overdose interventions have emerged in affected communities throughout the United States (US). The objective of this scoping review is to identify US-based post-overdose intervention models (1) described in peer-reviewed literature and (2) implemented in public health and community settings.

Methods

Using the adapted PRISMA Checklist for Scoping Reviews, we searched PubMed, PsychInfo, Academic OneFile, and federal and state databases for peer-reviewed and gray literature descriptions of post-overdose programs. We developed search strings with a reference librarian. We included studies or programs with at least the following information available: name of program, description of key components, intervention team, and intervention timing.

Results

We identified a total of 27 programs, 3 from the peer-reviewed literature and 24 from the gray literature. 9 programs operated out of the ED, while 18 programs provided post-overdose support in other ways: through home or overdose location visits, mobile means, or as law enforcement diversion. Commonly, they include partnerships among public safety and community service providers.

Conclusions

Programs are emerging throughout the US to care for individuals after a nonfatal opioid overdose. There is variability in the timing, components, and follow-up in these programs and little is known about their effectiveness. Future work should focus on evaluation and testing of post-overdose programs so that best practices for care can be implemented.

Dr. Raymond Oenbrink