PROJECT SUMMARY/ABSTRACT
The escalating opioid overdose epidemic is one of the most serious public health problems confronting the
U.S. In 2014, a record 47,055 people died from a drug overdose in the U.S., which outnumbered deaths
from motor vehicle crashes by approximately one and a half times. Heroin and misuse of prescription
Death due to drug overdose is a significant and
rising cause of mortality and morbidity in Philadelphia. In 2015, almost 700 drug overdose deaths were
opioids
contributed to a majority of drug overdoses in 2014.
reported in Philadelphia – twice as many as deaths from homicide. In response, health policy, legislation,
and research funding are increasingly converging in support of the distribution of naloxone, an opioid
antagonist, and community-based opioid overdose prevention programs (OPP). The success of OPP is
contingent upon the willingness and effectiveness of bystanders to respond to an overdose event and
administer naloxone. Emergency Response Communities (ERC) are specialized smartphone-based social
networks in which members are approved carriers and/or potential users of a specific medication, such as
naloxone. The ERC approach is ideally suited to support, facilitate, and encourage naloxone administration
in opioid overdose emergencies, but is untested to date. The model combines GPS and IP-location tracking
to identify potential opioid overdose through a smartphone application or app. Towards this end, we are
proposing to utilize an ERC in the development and pilot testing of a
smartphone app-based naxolone
intervention (ERC-NAX) in Philadelphia.
Research is needed to understand the needs and barriers in
communities at high-risk for opioid overdose that will enable effective design, adaption, and implementation
of an ERC-NAX app.
pursue three specific
Guided by preliminary data from study investigators, the proposed pilot project will
aims: 1) Identify barriers and facilitators of acceptance and use of a smartphone-
based ERC naloxone intervention; 2) Pilot test the implementation of ERC-NAX in an ERC consisting of 55
non-medical opioid users and 55 community members; 3) Synthesize knowledge acquired in Aims 1 and 2
to be used in a subsequent R01 study to conduct a large-scale, multi-site implementation trial. This 3-year
study will provide actionable evidence regarding the viability and acceptance of an app-based naloxone
intervention following the ERC model. It will be developed and tested in partnership with two community
partners in Philadelphia with extensive experience in overdose prevention. This proposed intervention is
significant since it leverages the growing success of OPP and will empower communities
at high-risk for
to provide rapid, secure, and effective emergency response in the event of overdose. This
novel intervention, which is designed to augment emergency medical services in the rapid delivery of
opioid overdose
naloxone to overdose victims, may be effective at deescalating the epidemic of opioid overdose fatalities in
Philadelphia and communities elsewhere.