Via Research Recognition Day Program VCOM-Carolinas 2025

Clinical Educational Research

Utilizing Naloxone Education to Reduce the Mortality and Morbidity Rate of Overdose Deaths within Opioid-Exposed Populations Anna M. Marchek M.A. 1 , Julia P. Wolf B.S. 1 , Georgia H. O’Leary M.A. 1 , Gabriela Pages M.P.H. 1 , Madison C. Benefield B.S. 1 , Brooke Bennett B.S. 1 , Priyanka Arunkumar M.A. 1 , Marc Burrows LMSW 2 , David Redden PhD 3 , Alexis M. Stoner PhD, MPH 1 , Jeff Cashman D.O. 1

1. Edward Via College of Osteopathic Medicine, Carolinas Campus, Spartanburg, SC 2. Challenges Inc., Greenville, SC 3. Edward Via College of Osteopathic Medicine, Auburn Campus, Auburn, AL

Introduction

Results

Discussion and Conclusion

References Discussion: • Confidence significantly increased in the educational group, confirming our hypothesis. The majority of those who declined education had prior naloxone training, which may explain unchanged confidence levels and higher ratings in the non-educated group. • Our study found that most participants would be willing to intervene and administer naloxone in the event of an opioid overdose after proper education, which aligns with previous studies. • Results show a discrepancy between frequency of witnessed opioid overdoses and frequency of naloxone utilization; this may be explained by lack of naloxone education, discomfort administering naloxone, or limited access to naloxone, which agrees with previous literature. • Limitation in this study includes recall bias, social desirability bias, and the types of naloxone available on the mobile unit for distribution. • Further investigation is needed to determine the role of age, gender, and race in the setting of overdose prevention and the impact of bystander measures. Conclusion: This study demonstrates that by increasing access, education, and confidence using naloxone, we can empower individuals to intervene with naloxone utilization and prevent opioid related overdoses. The authors would like to thank Kris Stepp from Challenges, Inc for his contributions to this project. Ethical design of study: approved as exempt by the Edward Via College of Osteopathic Medicine Institutional Review Board (2082046-5). Acknowledgements • Ashrafioun L, Gamble S, Herrmann M, Baciewicz G. Evaluation of knowledge and confidence following opioid overdose prevention training: A comparison of types of training participants and naloxone administration methods. Subst Abus. 2016;37(1):76-81. doi: 10.1080/08897077.2015.1110550. Epub 2015 Oct 29. PMID: 26514071. • Marks KR, Oyler DR, Strickland JC, et al. Bystander preference for naloxone products: a field experiment. Harm Reduct J. 2023;20:171. https://doi.org/10.1186/s12954-023-00904-9 • Van de Mortel, TF. Faking It: Social desirability Response Bias in Self-report Research. Australian Journal of Advanced Nursing . 2008;25(4):40 – 48. https://doi.org/https://search.informit.org/doi/10.3316/informit.210155003844269 • Giglio RE, Li G, DiMaggio CJ. Effectiveness of bystander naloxone administration and overdose education programs: a meta-analysis. Inj. Epidemiol. 2015;2(10). https://doi.org/10.1186/s40621-015-0041-8

Context: South Carolina experienced a 25% increase in overdose deaths from 2020-2021, primarily due to opioids. This study, conducted with Challenges Inc., a mobile overdose prevention service in Greenville, SC, focused on high-risk populations often overlooked in research. Unlike prior studies targeting treatment-seeking individuals, this study examined overdose exposure and naloxone experience among those actively utilizing harm-reduction services. Research Question: This study aimed to explore whether education on naloxone administration enhances confidence in individuals utilizing harm-reduction services. Additionally, it assessed the bystander effect to understand its potential impact on overdose prevention efforts. Study Design: This study, conducted in Greenville, SC, utilized a cross-sectional pre and post design that included weekly data collection with Challenges Inc. mobile unit site from January to May 2024 with an anticipated enrollment goal of 100 participants. Intervention : Methods 2. Baseline Survey: Capturing demographics, prior naloxone and opioid exposures, pre-confidence rating, and bystander measures. 3. Decision Point: Does the participant opt into training? • Yes: Proceed to educational training, then complete post-survey questions. • No: Directly complete post-survey questions. 4. End of participation: Option to receive Naloxone supply. Study data logged and resources distributed. 1. Start : Participants enrolled and consent.

Table 1. Baseline Demographics and Opioid Measures. Demographic data is expressed as n, with total n=100. Previous naloxone experience was significantly associated with age (p < 0.001) and gender (p = 0.02), but not with race (p= 0.06). Age, gender, and race were not associated with frequency of naloxone administration. When measuring bystander effect, 96% of participants agreed or strongly agreed with administering naloxone, 2% were neutral, and 2% disagreed or strongly disagreed.

6

**p < 0.0001

p = 0.25

4.96

4.83

5

4.71

4.15

4

3

Pre Post

2

1

Confidence Rating (0-5)

0

No

Yes

Agreed to Education

Figure 1: Ordinal measure of comfort administering naloxone comparing pre vs. post educational confidence . There was a significant increase in confidence for naloxone administration following education from 4.15 (± 1.08) to 4.83 (± 0.41) (p<0.0001), while those who declined naloxone education did not show a significant change in confidence (4.71 (± 0.81) to 4.96 (± 0.18) (p = 0.25)). Of the 28 participants that did not receive education, 27 had prior naloxone training, while 1 participant was not interested.

2025 Research Recognition Day

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