Naloxone Training Among Sorority-Affiliated College Students: An Observational Study
Shameka L Cody1, Christina J Ezemenaka, Cheryl B Hines
1Shameka L. Cody is an associate professor at the Capstone College of Nursing, University of Alabama, Tuscaloosa, where Cheryl B. Hines is a clinical assistant professor (retired). Christina J. Ezemenaka is an assistant professor at the University of Mississippi Medical Center, Jackson. Stella M. Rogers is a staff nurse at the Mayo Clinic Hospital, Rochester, MN. Sharlene D. Newman is a professor of psychology at the Barefield College of Arts and Sciences, University of Alabama, Tuscaloosa, and the executive director of the university's Alabama Life Research Institute. Contact author: Shameka L. Cody, slcody@ua.edu . The authors have disclosed no potential conflicts of interest, financial or otherwise.
Background:
As a population, college students are known to be at risk for adverse substance use-related events, such as opioid overdose, as they seek relief from academic and social stressors. Sorority affiliation in this population is reputed to be another risk factor for increased substance use and misuse. Many college students are not aware that illicitly made fentanyl is often mixed with other commonly used substances, such as marijuana and cocaine (among others), potentially leading to unintentional overdose and even death. The timely administration of naloxone, an opioid antagonist, can save lives.
Purpose:
This observational pre-post study examined college-age, sorority-affiliated students' knowledge of opioids, opioid toxicity, and opioid overdose response both before and after an educational lecture and hands-on naloxone training. Participants' perceptions about the intervention's effectiveness were also explored.
Methods:
Eighty-four participants completed a knowledge-assessment questionnaire prior to receiving a brief lecture about opioids. The investigators then gave a hands-on training, demonstrating proper overdose response procedures and intranasal naloxone administration using a low-fidelity simulation manikin. Participants were then given the optional opportunity to practice and submit a return demonstration, which was scored using a behavioral rubric. A posttest questionnaire identical to the first was administered following this training. Lastly, an intervention effectiveness survey was administered to assess participants' understanding of and comfort level in responding to opioid overdose events. Participant characteristics and perceptions of the training's effectiveness were summarized using descriptive statistics. Paired t tests were used to compare pre- and posttest means.
Results:
Mean posttest total scores as well as posttest scores for individual components, including opioid knowledge, opioid toxicity, and opioid overdose response, were all significantly higher than mean pretest scores, indicating improvement following the hands-on training. The mean score on the behavioral rubric was 100 out of 100, indicating that of those participants who volunteered to practice and demonstrate responding to a simulated opioid overdose scenario, all responded correctly.
Conclusions:
This novel intervention, which combined didactic with hands-on learning methods, led to demonstrated improvements in knowledge of opioids, opioid toxicity, and opioid overdose response among sorority-affiliated college students. Routinely providing opioid education and practical hands-on naloxone training in college settings is recommended, and future studies should investigate students' long-term knowledge retention and real-world application of skills learned.
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