Implementation of a Naloxone Distribution Program in an Inpatient Addiction Service: A Case Study
Bibliographic record
Abstract
Opioid overdose is a major public health burden worldwide. While the development of community based opioid overdose prevention programs have expanded in recent years, the implementation of such programs for patients in a hospital setting is not well described. This case report describes the implementation of British Columbia's Provincial Take Home Naloxone Program to patients evaluated by the Addiction Medicine Consult Team at St. Paul's Hospital in Vancouver, Canada between August 2014 and August 2015. During this period, 61 individuals were educated on the use of naloxone and were trained on how to administer it intramuscularly in the suspected case of an opioid overdose. In total, 23 naloxone kits were dispensed for future use in the community upon discharge. Overall, the Take Home Naloxone program has been recognized as a worthwhile initiative by patients, physicians of the addiction medicine consult team and other interdisciplinary hospital staff. Given the ongoing burden of disease attributable to opioid overdose and the feasibility of providing naloxone education and take-home kits to high-risk hospitalized patients with an opioid use disorder and their family and friends, these findings underscore the unique opportunity that exists for overdose prevention interventions in an acute care setting. Keywords: naloxone, overdose, implementation, harm reduction, Vancouver Les surdoses d'opioïdes sont un fardeau mondial de santé publique. Bien que le développement de programmes communautaires de prévention en surdose d'opioïdes ait crû considérablement au cours des dernières années, l'implantation de tels programmes en milieu hospitalier est peu décrit. Cette étude de cas décrit l'implantation en Colombie-Britannique du programme provincial Take Home Naloxone pour des patients évalués par l’équipe de consultation en toxicomanie à l'hôpital St. Paul's de Vancouver, Canada entre le mois d'août 2014 et le mois d'août 2015. Pendant cette période, 61 individus ont été informés sur l'utilisation du naloxone et formés sur son administration intramusculaire en situation de surdose d'opioïdes suspectée. Au total, 23 ensembles de naloxone ont été distribués pour une utilisation future dans la communauté. Dans l'ensemble, les patients, les médecins de l’équipe de consultation en toxicomanie et le personnel interdisciplinaire de l'hôpital ont reconnu le programme Take Home Naloxone comme une initiative valable. Étant donné le fardeau actuel attribué aux surdoses d'opioïdes et la faisabilité d'offrir de l'information sur la naloxone et des ensembles à emporter aux patients hospitalisés les plus à risque, à leur famille et à leurs amis, ces données soulignent l'opportunité unique qui existent d'intervenir en prévention des surdoses en établissements de soins aigus. Mots clés: naloxone, surdose, implantation, réduction des méfaits, Vancouver
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.010 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".