Naloxone Use, 911 Calls, and Emergency Visits After Nonfatal Overdose.

Area of Science:

• Public Health
• Emergency Medicine
• Addiction Science

Background:

• Nonfatal overdose (NFOD) events are critical points for intervention.
• Understanding service engagement after NFOD is crucial for improving postoverdose care.
• Layperson naloxone administration may influence emergency service utilization.

Purpose of the Study:

• To examine patterns of service use following a nonfatal overdose (NFOD).
• To identify reasons for not seeking emergency medical services after an NFOD.
• To inform strategies for enhanced postoverdose care.

Main Methods:

• Cross-sectional telephone survey of 2097 adults with recent cocaine, opioid, or methamphetamine use.
• Recruitment from harm-reduction, treatment, and social services organizations across four states.
• Analysis of naloxone use, 911 calls, ED visits, and reasons for non-engagement with emergency services.

Main Results:

• 25.7% of participants experienced an NFOD in the prior year.
• Naloxone was used in 82.1% of recent NFODs; 911 was called in 61.3%; ED visits occurred in 47.0%.
• Reasons for not calling 911 included regaining consciousness without naloxone (28.6%) or bystander naloxone administration (26.8%).

Conclusions:

• Fewer than half of recent nonfatal overdose events resulted in an emergency department visit.
• Postoverdose care policies should address both those who engage with emergency services and those who do not.
• Targeted interventions are needed to improve outcomes for all overdose survivors.