The Emergency Department as an Opportunity for Naloxone Distribution.
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Introduction:Substance use disorders, including opioid use disorders, are a major public health concern in the United States. Between 2005 and 2014, the rate of opioid-related emergency department (ED) visits nearly doubled, from 89.1 per 100,000 persons in 2005 to 177.7 per 100,000 persons in 2014. Thus, the ED presents a distinctive opportunity for harm-reduction strategies such as distribution of naloxone to patients who are at risk for an opioid overdose. Methods:We conducted a systematic review of all existing literature related to naloxone distribution from the ED. We included only those articles published in peer-reviewed journals that described results relating to naloxone distribution from the ED. Results:Of the 2,286 articles we identified from the search, five met the inclusion criteria and had direct relevance to naloxone distribution from the ED setting. Across the studies, we found variation in the methods of implementation and evaluation of take-home naloxone programs in the ED. In the three studies that attempted patient follow-up, success was low, limiting the evidence for the programs' effectiveness. Overall, in the included studies there is evidence that distributing take-home naloxone from the ED has the potential for harm reduction; however, the uptake of the practice remained low. Barriers to implementation included time allocated for training hospital staff and the burden on workflow. Conclusion:This systematic review of the best evidence available supports the ED as a potential setting for naloxone distribution for overdose reversal in the community. The variability of the implementation methods across the studies highlights the need for future research to determine the most effective practices.
Emergency Service, Hospital
Published Version (Please cite this version)10.5811/westjem.2018.8.38829
Publication InfoMuzyk, Andrew; Schramm-Sapyta, Nicole; Freiermuth, Caroline; Gunn, Alexander H; Smothers, Zachary PW; & MacEachern, Mark (2018). The Emergency Department as an Opportunity for Naloxone Distribution. The western journal of emergency medicine, 19(6). pp. 1036-1042. 10.5811/westjem.2018.8.38829. Retrieved from https://hdl.handle.net/10161/17825.
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Assistant Professor of Surgery
Associate Professor of the Practice of Medical Education
Dr. Andrew Muzyk is an Associate Professor of the Practice of Medical Education at Duke University School of Medicine in Durham, NC and an Associate Professor in the Department of Pharmacy Practice at Campbell University College of Pharmacy and Health Sciences in Buies Creek, NC. Dr. Muzyk also holds a Clinical Associate appointment in the Duke University School of Nursing. Dr. Muzyk's responsibilities include teaching students across numerous health professions programs, rounding as a c
Assistant Professor of the Practice in the Duke Institute for Brain Sciences
Drug Addiction is a complex disease with genetic, psychological, and societal causes and consequences. We know that some people can take drugs recreationally for years, while others quickly fall victim to addiction. What causes this distinction? And, how can we help those who suffer from addiction? I have worked in rodent models for many years, examining the neurobiological bases of vulnerability. I have shown that adolescence is one factor in determining vulnera
Alphabetical list of authors with Scholars@Duke profiles.