title: A Review of Opioid Overdose Prevention and Naloxone Prescribing: Implications for Translating Community Programming Into Clinical Practice.
abstract: BACKGROUND
  As physicians have increased opioid prescribing, overdose deaths from pharmaceutical opioids have substantially increased in the United States. Naloxone hydrochloride (naloxone), an opioid antagonist, is the standard of care for treatment of opioid induced respiratory depression. Since 1996, community-based programs have offered overdose prevention education and distributed naloxone for bystander administration to people who use opioids, particularly heroin. There is growing interest in translating overdose education and naloxone distribution (OEND) into conventional medical settings for patients who are prescribed pharmaceutical opioids. For this review, we summarized and classified existing publications on overdose education and naloxone distribution to identify evidence of effectiveness and opportunities for translation into conventional medical settings.
  
  
  METHODS
  For this review, we searched English language PubMed for articles on naloxone based on primary data collection from humans, including feasibility studies, program evaluations, surveys, qualitative studies, and studies comparing the effectiveness of different routes of naloxone administration. We also included cost-effectiveness studies.
  
  
  RESULTS
  We identified 41 articles that represented 5 categories: evaluations of OEND programs, effects of OEND programs on experiences and attitudes of participants, willingness of medical providers to prescribe naloxone, comparisons of different routes of naloxone administration, and the cost-effectiveness of naloxone.
  
  
  CONCLUSIONS
  Existing research suggests that people who are at risk for overdose and other bystanders are willing and able to be trained to prevent overdoses and administer naloxone. Counseling patients about the risks of opioid overdose and prescribing naloxone is an emerging clinical practice that may reduce fatalities from overdose while enhancing the safe prescribing of opioids.
authors.affiliation: a Division of General Internal Medicine , University of Colorado School of Medicine , Aurora , Colorado , USA.
authors.forename: Shane R
authors.initials: SR
authors.lastname: Mueller
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Walley
authors.forename: Susan L
authors.initials: SL
authors.lastname: Calcaterra
authors.forename: Jason M
authors.initials: JM
authors.lastname: Glanz
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Binswanger
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects*; D003153:Community Health Services / Q000379:methods*; D062787:Drug Overdose / Q000517:prevention & control*; D058006:General Practice / Q000379:methods*; D006297:Health Services Accessibility; D006801:Humans; D009270:Naloxone / Q000627:therapeutic use*; D010353:Patient Education as Topic
chemical_list: D000701:Analgesics, Opioid; D009270:Naloxone
keywords: Prevention; opioids; overdose; primary care