Opioid-related deaths continue to take the lives of thousands in the U.S. each year; with non-fatal opioid-overdoses as a significant risk factor for a subsequent fatal overdoses. Post-overdose interventions are emerging in affected communities; using what support systems are available to assist in the program design. Survivors often do not seek treatment or overdoses risk reduction service immediately; after an overdose for many reasons, including shame and stigma, and lack of referrals to substance use treatment.

In a scoping review article published in Preventative Medicine; Sarah M. Bagley, MD, MSc, medical director of the CATALYST (Center for Addiction Treatment for Adolescents/Young adults who use Substances) Clinic and addiction specialist at Boston Medical Center’s Grayken Center for Addiction, provides an overview about; the emerging prevalence of post-overdose intervention programs in the U.S. and the variety of methods that communities and states are using based on availability of resources and support.

Non-fatal overdose

However, for the review, researchers examined articles published between 1999; and January 2019 that specifically described a specific post-overdose program.  Therefore, a total of 27 unique programs identified for qualitative synthesis; which were organized into five categories based on timing, setting, and collaborations emergency department-based, emergency department and home-based; home and/or overdose venue-based, mobile/not site-specific outreach, and diversion programs.

But some of the key takeaways from the review are: Nine post-overdose programs operated directly out of the emergency department; 18 programs provided post-overdose support in additional ways: Three were operated both in the ED and home setting, four were through mobile means or non-site specific, one was through law enforcement diversion, offering quick connections into treatment, 10 were based in the community where follow-up occurred in the homes or venues where the overdose took place

Individuals were either approached while still in the ED for a non-fatal overdose; or within one week of discharge; follow-up usually occurred between two and seven days. Many programs rely on collaboration between five departments; law enforcement, emergency medical services, and public health departments to generate lists for those requiring follow-up post-overdoses.

Chronic illness programs

However, follow-ups typically involved a police/fire/sheriff’s officer and health clinician; or harm reduction specialist, including support and referrals for friends and family. Many programs peer-based found to be effective in other chronic illness programs; due to greater comfort and more credibility based on a shared experience

“We are at a time when post-overdose programs; are imperative to supporting people who are struggling with opioid use disorder,” said Bagley, who is also an assistant professor of medicine; and pediatrics at Boston University School of Medicine. “It is important to engage individuals in care after they have survived an overdose so that they can provide the services; and support necessary to reduce the risk of future overdose and prevent opioid-related fatalities in the U.S.”