THE SURVIVING OPIOID OVERDOSE WITH NALOXONE EDUCATION AND RESUSCITATION (SOON-ER) TRIAL: THE CO-DESIGN OF A TOOLKIT FOR OPIATE OVERDOSE CULMINATING IN A RANDOMIZED STUDY OF AN OPIOD OVERDOSE EDUCATION AND NALOXONE DISTRIBUTION INTERVENTION FOR LAYPEOPLE IN AMBULATORY AND INPATIENT SETTINGS
The SOON-ER project aims to generate an evidence-based Overdose Education and Naloxone Distribution (OEND) toolkit, to be offered in clinical settings, that allows for brief patient training with a new nasal naloxone delivery service. The SOON-ER project includes simulation testing to determine if offering OEND programs in clinical settings can improve bystander resuscitative performance in overdose situations. It will measure the effect of a brief OEND training on overdose knowledge and attitudes in patients at risk for opioid overdose.
The ultimate goal of this ongoing project is to transform care for the thousands of Canadians affected by opiod overdose and to integrate overdose prevention into routine clinical practice in Canada.
Overdose from opioids such as oxycodone, fentanyl, and heroin are now responsible for over 100,000 deaths per year worldwide. Overdoses in Ontario result in more years of life lost than HIV, pneumonia, or influenza.
Overdose education and naloxone distribution (OEND) could be an effective method of combatting the overdose epidemic. Typically, OEND programs are offered in non-clinical settings, such as community harm reduction centers, and involve lengthy patient training. Consequently they do not reach many patients at risk of overdose.
Having OEND in clinical settings (such as hospitals and emergency departments) could increase the number of at-risk patients reached by OEND programs.The SOON-ER project seeks to compare the efficacy of OEND programs in clinical vs. non-clinical settings to maximize the impact of OEND in emergency departments, family practices, inpatient settings, and opiod substitution clinics by creating a toolkit for overdose first aid by lay responders.
OCAD University led the design phase of the SOON-ER project, addressing the need for an integrated design approach to the opiate crisis. The design process included extensive community and stakeholder engagement in iterative workshops over 9 months. The result was the development of an ultra-brief first aid training animation and the creation of a toolkit with nasal naloxone, for lay response to overdose. Key aspects of the design process addressed the context of overdose, stigma, and marginalisation.
To test the effectiveness of the new system, SOON-ER will recruit patients at risk of opioid overdose in the emergency department, family practices, opioid substitution clinics and inpatient settings. These patients will be trained using the new toolkit or were referred to a conventional community OEND program. The success of patient responses to opioid overdose situations will be evaluated and compared in simulated overdose situations.
Project results from SOON-ER will be disseminated in Canada and abroad.
For more information, please visit http://www.soonerproject.org/ and http://stmichaelshospitalresearch.ca/research-programs/rescu/our-research/sooner/