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A new Trigger Checklist (TC) tool improved assertive outreach for drug-related deaths (DRDs) in the Scottish Highlands. This intervention increased the time between non-fatal overdoses and prevented drug-related deaths during the study period.

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Area of Science:

  • Public Health
  • Addiction Medicine
  • Health Services Research

Background:

  • Drug-related deaths (DRDs) represent a significant global health challenge, with Scotland experiencing high mortality rates.
  • Despite some improvements, specific regions like the Scottish Highlands face rising DRD rates, necessitating targeted interventions.
  • Assertive outreach to high-risk individuals is a key strategy for harm reduction in vulnerable populations.

Purpose of the Study:

  • To test and implement the Trigger Checklist (TC) tool for identifying individuals at high risk of DRDs.
  • To initiate assertive outreach services in a remote Highland area using the TC tool.
  • To evaluate the effectiveness of the TC-initiated outreach in reducing non-fatal overdoses and drug-related deaths.

Main Methods:

  • The Model for Improvement framework guided the project, incorporating collaborative problem-solving and Plan, Do, Study, Act cycles.
  • A standardized Trigger Checklist (TC) was developed and implemented to flag individuals requiring assertive outreach.
  • Data collection included TC referrals, outreach timeliness (within 48 hours), and time intervals between non-fatal overdoses (NFODs).

Main Results:

  • The standardized TC was successfully implemented, with 100% of 48 referrals receiving assertive outreach within 48 hours.
  • The median interval between non-fatal overdoses significantly increased from 6.5 days to 23 days post-implementation.
  • No drug-related deaths were recorded in the locality during the 8-month project period, with intervals between NFODs exceeding 90 days.

Conclusions:

  • The Trigger Checklist (TC) is an effective tool for initiating assertive outreach to reduce drug-related harm in high-risk populations.
  • The intervention demonstrated a significant positive impact on reducing non-fatal overdoses and preventing drug-related deaths in a remote setting.
  • Further validation and standardization of the TC are recommended for broader implementation in areas with high-risk populations, including rural emergency departments.