Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 15;23(1):888.
doi: 10.1186/s12889-023-15554-6.

Considerations for the design of overdose education and naloxone distribution interventions: results of a multi-stakeholder workshop

Kate Sellen  1 , Benjamin Markowitz  2 , Janet A Parsons  2 , Pamela Leece  3 , Curtis Handford  4   5 , Nick Goso  6 , Shaun Hopkins  7 , Michelle Klaiman  8 , Rita Shahin  7 , Geoffrey Milos  9 , Amy Wright  9 , Mercy Charles  2 , Laurie Morrison  2 , Carol Strike  10 , Aaron Orkin  5   9   10   11 ; SOONER Investigators
Affiliations

Considerations for the design of overdose education and naloxone distribution interventions: results of a multi-stakeholder workshop

Kate Sellen et al. BMC Public Health. .

Abstract

Introduction: Opioid overdose epidemic is a public health crisis that is impacting communities around the world. Overdose education and naloxone distribution programs equip and train lay people to respond in the event of an overdose. We aimed to understand factors to consider for the design of naloxone distribution programs in point-of-care settings from the point of view of community stakeholders.

Methods: We hosted a multi-stakeholder co-design workshop to elicit suggestions for a naloxone distribution program. We recruited people with lived experience of opioid overdose, community representatives, and other stakeholders from family practice, emergency medicine, addictions medicine, and public health to participate in a full-day facilitated co-design discussion wherein large and small group discussions were audio-recorded, transcribed and analysed using thematic approaches.

Results: A total of twenty-four participants participated in the multi-stakeholder workshop from five stakeholder groups including geographic and setting diversity. Collaborative dialogue and shared storytelling revealed seven considerations for the design of naloxone distribution programs specific to training needs and the provision of naloxone, these are: recognizing overdose, how much naloxone, impact of stigma, legal risk of responding, position as conventional first aid, friends and family as responders, support to call 911.

Conclusion: To create an naloxone distribution program in emergency departments, family practice and substance use treatment services, stigma is a central design consideration for training and naloxone kits. Design choices that reference the iconography, type, and form of materials associated with first aid have the potential to satisfy the need to de-stigmatize overdose response.

Keywords: Co-design; Harm reduction; Naloxone distribution; Opioid overdose; Overdose education; Stigma.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Journey map: family and friends of people with lived experience of overdose
See this image and copyright information in PMC

References

    1. Public Health Agency of Canada . Opioid- and Stimulant-related Harms in Canada. Canada.ca. 2020.
    1. McDonald R, Strang J. Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria. Addiction. 2016;111(7):1177–87. doi: 10.1111/add.13326. - DOI - PMC - PubMed
    1. Walley AY, Xuan Z, Hackman HH, Quinn E, Doe-Simkins M, Sorensen-Alawad A, et al. Opioid overdose rates and implementation of overdose education and nasal naloxone distribution in Massachusetts: interrupted time series analysis. BMJ. 2013;346(jan30 5):f174–4. doi: 10.1136/bmj.f174. - DOI - PMC - PubMed
    1. Heavey SC, Burstein G, Moore C, Homish GG. Overdose education and naloxone distribution program attendees: who attends, what do they know, and how do they feel? J Public Health Manag Pract. 2018;24(1):63. doi: 10.1097/PHH.0000000000000538. - DOI - PMC - PubMed
    1. Razaghizad A, Windle SB, Filion KB, Gore G, Kudrina I, Paraskevopoulos E, Kimmelman J, Martel MO, Eisenberg MJ. The effect of overdose education and naloxone distribution: an umbrella review of systematic reviews. Am J Public Health. 2021;111(8):e1–2. doi: 10.2105/AJPH.2021.306306. - DOI - PMC - PubMed

Publication types

MeSH terms

Grants and funding