DESCRIPTION (provided by applicant): Nationally, drug poisonings (overdoses) are the second leading cause of accidental death among adults and the leading cause of adult accidental death in Rhode Island and in 15 other states. Individuals leaving prison or jail are at high risk for death from overdose, especially during the first two weeks after release. This study seeks to directly address this problem through a prevention intervention tailored to the prison setting. Specific aims are to: 1) create an overdose prevention and naloxone administration training Digital Video Disc (DVD) for use with prisoners prior to their release from incarceration; 2) assess the feasibility and acceptability of an opiate overdose prevention and naloxone administration educational DVD based intervention for inmates leaving a correctional facility; and 3)assess participants' retention of knowledge, confidence, and demonstration of critical opiate overdose prevention/naloxone administration behaviors three months after receiving the intervention. The targeted population is inmates who are within four weeks of release from the Rhode Island Department of Corrections who are themselves or know people who are involved in drug use. To accomplish the specific aims, a DVD intervention will be developed based on established training protocols and the didactic training tailored for delivery in a prison setting. Feedback from former prisoners, trainers, prison staff, and national experts in overdose prevention will inform the DVD development. In a field test conducted over a 12-month period, 125 participants will take part in a group format training that utilizes DVD and didactic components. Participants who successfully complete the training will receive naloxone when released from incarceration. Follow-up to assess retention and acceptability of the intervention will occur 3 months post release from incarceration at a community-located study site. Findings from this study will provide pilot data for a future randomized controlled trial study. Results will also expand the field both by its implementation in an incarcerated setting and by evaluating retention of key opiate overdose prevention and naloxone administration knowledge, confidence, and demonstration of skills that have not been formally assessed.
PUBLIC HEALTH RELEVANCE: With injection drug use and other opiate use leading to a substantial increase in overdose mortality in the United States, and a substantial proportion of that traditionally hard-to-reach population passing through correctional facilities each year, there exists a tremendous opportunity to provide critical education information regarding overdose prevention in the incarcerated setting. This application aims to evaluate a naloxone education intervention among prison inmates at the Rhode Island Department of Corrections (RIDOC). Data generated through this pilot study will be instrumental for developing larger scale intervention trials which will assess effectiveness of a naloxone intervention upon release from incarceration.