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. 2023 Jun 16:8:100173.
doi: 10.1016/j.dadr.2023.100173. Online ahead of print.

Disruptions to naloxone training among lay and occupational responders in Maryland during the emergence of COVID-19: early impacts, recovery, and lessons learned

Himani Byregowda  1 , Catherine Tomko  2 , Kristin E Schneider  2 , Erin Russell  3 , Renee M Johnson  1 , Ryoko Susukida  1 , Saba Rouhani  4 , Taylor Parnham  2 , Ju Nyeong Park  5
Affiliations

Disruptions to naloxone training among lay and occupational responders in Maryland during the emergence of COVID-19: early impacts, recovery, and lessons learned

Himani Byregowda et al. Drug Alcohol Depend Rep. .

Abstract

Background: : Opioid overdose death rates increased during the COVID-19 pandemic. Disruptions in community-based naloxone trainings could have reduced the likelihood of overdose reversal and increased the chances of a fatal overdose. We investigated changes in the number of people trained in naloxone administration and distribution in Maryland before, during, and after COVID-related stay-at-home orders.

Methods: : Data on naloxone training are from the Maryland Department of Health. We used interrupted time series models to estimate changes in average monthly number of people trained: [1] pre-interruption (4/2019-3/2020), [2] 1-month post-interruption (4/2020-5/2020), and [3] 12-months post-interruption (4/2020-3/2021). Trainees were classified as lay (e.g., people who use drugs) or occupational (e.g., law enforcement officers and harm reduction workers) responders.

Results: : There were 101,332 trainees; 54.1% lay, 21.5% occupational, and 23.4% unknown responder status. We observed a decrease in the average monthly number of trainees in the pre-interruption period (-235, p<0.001), a larger decrease of 93.2% during the 1-month post-interruption (-846, p=0.013), and an increase 12-months post-interruption (+217, p<0.001). There was a significant decrease among occupational responders 1-month post-interruption, and a significant increase among lay responders in the 12-month post-interruption period.

Conclusions: : Findings suggest a marked decrease in naloxone trainees immediately after stay-at-home order, followed by a moderate rebound in the 12-months after stay-at-home order. The decrease in occupational responders trained may have limited access to naloxone, but would likely have been offset by increases in number of lay responders trained. Strengthening lay and occupational responder connections could maintain naloxone distribution during public health crises.

Keywords: COVID-19; harm reduction; naloxone; overdose prevention.

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Conflict of interest statement

None

Figures

Fig. 1
Fig. 1
Plot of ITS model-based estimates of change in the average monthly number of trainees before and after COVID-19 related stay-at-home orders in Maryland.
Fig. 2
Fig. 2
Plot of ITS model-based estimates of change in the average monthly number of trainees before and after COVID-19 related stay-at-home orders in Maryland, by type of responder.
See this image and copyright information in PMC

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