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A Systematic Review of Community Opioid Overdose Prevention and Naloxone Distribution Programs

Clark, Angela K. MSN, RN; Wilder, Christine M. MD; Winstanley, Erin L. PhD

doi: 10.1097/ADM.0000000000000034

Community-based opioid overdose prevention programs (OOPPs) that include the distribution of naloxone have increased in response to alarmingly high overdose rates in recent years. This systematic review describes the current state of the literature on OOPPs, with particular focus on the effectiveness of these programs. We used systematic search criteria to identify relevant articles, which we abstracted and assigned a quality assessment score. Nineteen articles evaluating OOPPs met the search criteria for this systematic review. Principal findings included participant demographics, the number of naloxone administrations, percentage of survival in overdose victims receiving naloxone, post–naloxone administration outcome measures, OOPP characteristics, changes in knowledge pertaining to overdose responses, and barriers to naloxone administration during overdose responses. The current evidence from nonrandomized studies suggests that bystanders (mostly opioid users) can and will use naloxone to reverse opioid overdoses when properly trained, and that this training can be done successfully through OOPPs.

From the College of Nursing (AKC), University of Cincinnati, and Department of Psychiatry and Behavioral Neuroscience (CMW, ELW), University of Cincinnati College of Medicine, Cincinnati, OH.

Send correspondence and reprint requests to Christine M. Wilder, MD, Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Ave, Suite 104, Cincinnati, OH 45229. E-mail:

The authors declare no conflicts of interest.

Received October 17, 2013

Accepted February 20, 2013

© 2014 American Society of Addiction Medicine