Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study
Background: Opioid overdoses differentially affect demographic groups. Strategies to reduce overdose deaths, specifically overdose education and naloxone distribution (OEND), are not consistently delivered equitably. Methods: The HEALing Communities StudySM (HCS) is a cluster-randomized trial design...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Drug and Alcohol Dependence Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S277272462300077X |
| _version_ | 1797249072116006912 |
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| author | Douglas R. Oyler Hannah K. Knudsen Carrie B. Oser Sharon L. Walsh Monica Roberts Shawn R. Nigam Philip M. Westgate Patricia R. Freeman |
| author_facet | Douglas R. Oyler Hannah K. Knudsen Carrie B. Oser Sharon L. Walsh Monica Roberts Shawn R. Nigam Philip M. Westgate Patricia R. Freeman |
| author_sort | Douglas R. Oyler |
| collection | DOAJ |
| description | Background: Opioid overdoses differentially affect demographic groups. Strategies to reduce overdose deaths, specifically overdose education and naloxone distribution (OEND), are not consistently delivered equitably. Methods: The HEALing Communities StudySM (HCS) is a cluster-randomized trial designed to implement evidence-based practices, including OEND, to reduce overdose deaths across communities. Individuals receiving OEND in eight Kentucky counties between January 2020 and June 2022 provided demographics and overdose history. Recipient characteristics were compared to opioid overdose decedent characteristics to evaluate whether OEND was equitably delivered to the target population. Recipient characteristics were also analyzed based on whether OEND was delivered in criminal justice, behavioral health, or health care facilities. Results: A total of 26,273 demographic records were analyzed from 137 partner agencies. Most agencies were in behavioral health (85.6 %) or criminal justice sectors (10.4 %). About half of OEND recipients were male (50.6 %), which was significantly lower than the 70.3 % of overdose decedents who were male, (p<0.001). OEND recipients tended to be younger than overdose decedents, but there were not significant differences in race/ethnicity between OEND recipients and overdose decedents. Over 40 % of OEND recipients had overdosed, and 68.9 % had witnessed a prior overdose. There were notable differences across facility types, as males and Black individuals accounted for fewer OEND recipients in addiction treatment facilities compared to jails. Conclusion: Although OEND recipients’ demographics resembled those of decedents, specific attention should be paid to ensuring equitable OEND access. Variation in OEND uptake by facility type may reflect biases and barriers to care. |
| first_indexed | 2024-03-08T14:25:02Z |
| format | Article |
| id | doaj.art-47a4f500d0354e128140220c2d88fc86 |
| institution | Directory Open Access Journal |
| issn | 2772-7246 |
| language | English |
| last_indexed | 2024-04-24T20:24:40Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Drug and Alcohol Dependence Reports |
| spelling | doaj.art-47a4f500d0354e128140220c2d88fc862024-03-22T05:41:16ZengElsevierDrug and Alcohol Dependence Reports2772-72462024-03-0110100207Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities StudyDouglas R. Oyler0Hannah K. Knudsen1Carrie B. Oser2Sharon L. Walsh3Monica Roberts4Shawn R. Nigam5Philip M. Westgate6Patricia R. Freeman7Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA; Corresponding author at: Assistant Professor of Pharmacy Practice and Science, 267 Healthy Kentucky Research Building, 760 Press Avenue, Lexington, KY 40536.Department of Behavioral Science and Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, KY, USADepartment of Sociology and Center on Drug and Alcohol Research, College of Arts and Sciences, University of Kentucky, Lexington, KY, USADepartment of Behavioral Science and Center on Drug and Alcohol Research, College of Medicine, University of Kentucky, Lexington, KY, USASubstance Use Priority Research Area, University of Kentucky, Lexington, KY, USADepartment of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USADepartment of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USADepartment of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USABackground: Opioid overdoses differentially affect demographic groups. Strategies to reduce overdose deaths, specifically overdose education and naloxone distribution (OEND), are not consistently delivered equitably. Methods: The HEALing Communities StudySM (HCS) is a cluster-randomized trial designed to implement evidence-based practices, including OEND, to reduce overdose deaths across communities. Individuals receiving OEND in eight Kentucky counties between January 2020 and June 2022 provided demographics and overdose history. Recipient characteristics were compared to opioid overdose decedent characteristics to evaluate whether OEND was equitably delivered to the target population. Recipient characteristics were also analyzed based on whether OEND was delivered in criminal justice, behavioral health, or health care facilities. Results: A total of 26,273 demographic records were analyzed from 137 partner agencies. Most agencies were in behavioral health (85.6 %) or criminal justice sectors (10.4 %). About half of OEND recipients were male (50.6 %), which was significantly lower than the 70.3 % of overdose decedents who were male, (p<0.001). OEND recipients tended to be younger than overdose decedents, but there were not significant differences in race/ethnicity between OEND recipients and overdose decedents. Over 40 % of OEND recipients had overdosed, and 68.9 % had witnessed a prior overdose. There were notable differences across facility types, as males and Black individuals accounted for fewer OEND recipients in addiction treatment facilities compared to jails. Conclusion: Although OEND recipients’ demographics resembled those of decedents, specific attention should be paid to ensuring equitable OEND access. Variation in OEND uptake by facility type may reflect biases and barriers to care.http://www.sciencedirect.com/science/article/pii/S277272462300077XNaloxoneOverdoseHealth equity |
| spellingShingle | Douglas R. Oyler Hannah K. Knudsen Carrie B. Oser Sharon L. Walsh Monica Roberts Shawn R. Nigam Philip M. Westgate Patricia R. Freeman Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study Drug and Alcohol Dependence Reports Naloxone Overdose Health equity |
| title | Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study |
| title_full | Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study |
| title_fullStr | Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study |
| title_full_unstemmed | Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study |
| title_short | Equity of overdose education and naloxone distribution provided in the Kentucky HEALing Communities Study |
| title_sort | equity of overdose education and naloxone distribution provided in the kentucky healing communities study |
| topic | Naloxone Overdose Health equity |
| url | http://www.sciencedirect.com/science/article/pii/S277272462300077X |
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