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APHA Scientific Session and Event Listing

Recorded presentation

Susan Sherman, PhD¹, Katherine Markham, MPH, CSW², Ananthy Thambinayagam¹, Sasha Rudenstine², Charles Vasquez², Steve Hoover², Sharon Stancliff, MD³, and Sandro Galea, MD, DrPH⁴. (1) Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6543, Baltimore, MD 21205, 410.614.3518, ssherman@jhsph.edu, (2) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 55 West 125th St., New York, NY 10027, (3) Harm Reduction Coalition, 22 West 27th Street, 5th Floor, New York, NY 10001, (4) Department of Epidemiology, University of Michigan School of Public Health, 1214 South University, Room 243, Ann Arbor, MI 48104

Background: In New York City (NYC), drug overdose accounts for nearly 900 deaths per year, more than in any other US city. An overdose prevention training (SKOOP) was initiated in March 2005 at five needle exchange programs throughout NYC. Injection drug users (IDUs) received training to reduce overdose risk and administer naloxone, an opiate antagonist. We conducted a qualitative study to understand IDUs' experiences during witnessed overdoses where naloxone was administered.

Methods: Semi-structured qualitative interviews (n=24) ascertained a number of domains, including participants': history of witnessing and experiencing overdoses, interventions during reported overdoses; interactions (when applicable) with emergency medical personal and police during overdose events, lessons learned during SKOOP training that influenced drug use behaviors; and actions taken during an overdose. Verbatim transcripts were coded and analyzed thematically.

Findings: Participants were 75% male, 52% white, and the median age was 42. Participants reported ever having witnessed an average of 15 overdoses and ever having experienced an average of two overdoses. During the most recently witnessed overdose event, 55% of participants administered naloxone. Additional revival methods used at time of overdose included rescue breathing and calling 911. Participants discussed barriers to calling 911, primarily fear of police and also described SKOOP's impact on increasing dialogue about overdose with other IDUs.

Conclusions: We found successful use of naloxone and other safe revival methods among IDUS. SKOOP not only directly impacts participants and IDUs who overdose and are saved, but also enhances social norms among IDUs about overdose prevention and naloxone administration.

Learning Objectives:

• To learn about injection drug users' experiences of participating in a overdose prevention and naloxone distribution program in New York City.
• To identify how injection drug users' responded to overdose events after they were trained in naloxone administration.
• To understand the meaning of overdose to injection drug users.

Keywords: Injection Drug Users, Prevention

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation