Low-Cost Intervention Reduces Risk of Opioid Overdose

Published in Brain Wise - Brainwise Fall 2019

Psychiatry associate professor and researcher Kelly Dunn is taking aim at a serious problem: the opioid overdoses that claim about 130 American lives every day. 

We saw a gap in the way people were thinking about addiction and overdose,” says Dunn, who has been studying the opioid epidemic since 2011. Until now, she says, much of the prevention effort has focused on people who use opioids illegally and not on patients treated for pain. 

What’s more, she says, prevention “was really about giving (overdose-reversing medication) naloxone, but there was little available to empower people to prevent them from getting to the point of overdosing and needing it.” 

Now, Dunn and colleagues Cecilia Bergeria, postdoctoral fellow in the Behavioral Pharmacology Research Unit; and Andrew Huhn, assistant professor of psychiatry, have created an intervention they believe can prevent some of those overdoses from happening in the first place. 

They developed an online, self-paced tutorial about opioids, risk factors for and symptoms of overdose, and what to do when someone overdoses. The intervention improves knowledge and reduces risky behaviors — such as mixing opioids with alcohol or taking them when alone — among pain patients as well as those who use the drugs illegally. 

With just a few words each on 33 slides, the intervention provides straightforward information and dispels potentially deadly misconceptions, such as the popular myth that injecting someone with saltwater will stop an overdose. 

A study, authored by Bergeria, Dunn and Huhn, in the journal Preventive Medicine, examines the effects of web-based interventions on three groups of opioid users: people who are prescribed opioid medication for acute pain, patients prescribed opioids for chronic pain and people without pain who take opioids illicitly.

The research shows that the intervention is effective for all three groups. What’s more, all three showed improved opioid knowledge immediately, as well as 30 days later. The researchers found that the acute pain group had the least opioid knowledge before the intervention. 

The authors say their investigation is the first to show “meaningful and sustained increases in opioid overdose knowledge and to simultaneously target three unique populations of people exposed to opioids who may be at heightened risk of overdose.” 

They are now working to make the intervention available to clinicians and patients. “We like this approach because staff members are very busy and don’t necessarily know how to teach interventions,” says Dunn. 

The study also looked at two formats for the intervention: a “mastery” style, with periodic quizzes that require correct answers in order to continue; and a “presentation” style, without the quizzes. They found that the mastery format caused more participants to drop out, without leading to any advantage in improved knowledge as compared to the presentation format. 

“The presentation version of this intervention may be of particular value because it is brief, user-friendly, well-accepted and recommended by participants, low-burden and scalable,” the researchers wrote. 

“It could have significant public health impact by reducing opioid overdose risk in people who are managing their acute or chronic pain with an opioid prescription, or who have no pain and are using opioids illicitly.”