Network Overdose Prevention for Drug Overdose

Overseen By Carl Latkin, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Johns Hopkins Bloomberg School of Public Health

Disqualifiers: Cognitive impairment, Physical inability, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

600 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test a social approach to preventing drug overdoses, focusing on people who use opioids. Participants will learn about overdose prevention and response, then teach their friends and family. One group will join peer education sessions, while another will receive standard health information. The trial seeks individuals who use opioids at least twice every two weeks, live in the Baltimore area, and are willing to involve a non-using friend or family member.

As an unphased trial, this study offers participants the chance to contribute to innovative community-based solutions for overdose prevention.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this social intervention is safe for overdose prevention?

Research has shown that social programs like network overdose prevention have been studied for safety and effectiveness. Previous studies found that people who use opioids can serve as effective peer educators. This indicates that the program safely involves participants in learning activities. The program teaches skills for preventing and responding to overdoses, which are generally low-risk activities. No reports of negative effects have been specifically linked to these educational sessions, indicating that participants handle them well. Although specific data on side effects from these sessions is lacking, the program's nature suggests it is safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the network overdose prevention approach because it aims to tackle drug overdoses by empowering people through peer education and network support. Unlike the standard practice of providing basic health education in a single session, this method involves multiple sessions where participants not only learn overdose prevention and response skills but also train to communicate these skills to non-drug-using members of their social network. This community-focused strategy has the potential to create a broader impact by spreading knowledge and resources beyond the individual, fostering a supportive environment that could lead to more effective overdose prevention.

What evidence suggests that this social intervention is effective for overdose prevention?

This trial will compare a peer education and network support intervention with the standard of care for overdose prevention. Research has shown that community-based education can effectively prevent drug overdoses. In past studies, individuals who use opioids received training to educate their peers about preventing and responding to overdoses. This method helps disseminate crucial information within communities, potentially reducing overdoses. Trained individuals can better inform and support those around them, promoting safer habits. Public health experts also believe that these community-focused efforts can improve outcomes related to overdoses over time. ^{1 2 3 6 7}

Who Is on the Research Team?

Carl Latkin, PhD

Principal Investigator

Johns Hopkins University

Are You a Good Fit for This Trial?

This trial is for adults over 18 who use opioids and live in the Baltimore area. They must have used illicit opioids at least twice in the past two weeks, be willing to teach others about overdose prevention, and recruit a non-using friend or family member. People with cognitive impairments that prevent informed consent or physical limitations for attending sessions cannot join.

Inclusion Criteria

Willing to engage in peer education

Self-reported illicit opioid use at least 2 times in the past two weeks

Living in the Baltimore metropolitan region

Exclusion Criteria

I can make my own health decisions and attend sessions in person.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants undergo 3 individual sessions focused on overdose prevention and response, training them to be Peer Educators. Non-drug using network members are offered one session.

3 sessions

Control

Participants receive the standard of care for overdose prevention in one session.

1 session

Follow-up

Participants are monitored for safety and effectiveness after intervention, focusing on drug overdoses and network member contacts.

3 months

What Are the Treatments Tested in This Trial?

Interventions

• Network overdose prevention

Trial Overview

The study is testing an intervention where people who use opioids become peer educators to help prevent overdoses, compared to standard health education. It builds on previous work showing opioid users can effectively educate their peers.

How Is the Trial Designed?

Group I: Experimental: Peer education and network support Experimental Treatment 1 Intervention

During sessions 1 and 2, participants will be taught information and skills pertaining to overdose prevention and response. During the 3rd session, participants will trained to talk to their non drug using network members in overdose prevention and response.

Group II: comparison: Standard of care of health education Active Control 2 Interventions

In one session, participants will receive the standard of care for overdose prevention.

Who Is Running the Clinical Trial?

Johns Hopkins Bloomberg School of Public Health

Lead Sponsor

Trials

441

Recruited

2,157,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Published Research Related to This Trial

A web-based educational intervention significantly improved opioid overdose knowledge among at-risk individuals, including those with acute pain, chronic pain, and illicit opioid users, with knowledge retention observed 30 days later.

The intervention also led to a reduction in risky behaviors, such as using opioids alone or with alcohol, indicating its potential effectiveness in preventing opioid overdoses across different populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized comparison of two web-based interventions on immediate and 30-day opioid overdose knowledge in three unique risk groups. Bergeria, CL., Huhn, AS., Dunn, KE.[2020]

Among 106 injection drug users in Los Angeles, those who could name at least one person in their social network who had received overdose prevention training were over three times more likely to have received training themselves, highlighting the influence of social networks on training participation.

The study suggests that leveraging social networks could be an effective strategy to increase participation in overdose prevention training among injection drug users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Personal social network factors associated with overdose prevention training participation. Wagner, KD., Iverson, E., Wong, CF., et al.[2023]

A study of 838 cocaine and opiate users found that having a larger number of injection drug users in one's social network is significantly linked to a higher risk of drug overdose.

Conflictual relationships within these social networks also correlated with increased overdose risk, indicating that targeting large drug networks could be an effective strategy for overdose prevention interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social network correlates of self-reported non-fatal overdose. Latkin, CA., Hua, W., Tobin, K.[2019]

The mobile medical unit in Chicago successfully provided care to 587 unique patients in underserved neighborhoods, addressing both COVID-19 vaccination and opioid use disorder treatment, particularly with buprenorphine.

This integrated approach not only facilitated immediate health needs but also allowed for the initiation of buprenorphine treatment, demonstrating its effectiveness in reaching marginalized populations and potentially reducing opioid overdose rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes of a mobile medical unit for low-threshold buprenorphine access targeting opioid overdose hot spots in Chicago. Messmer, SE., Elmes, AT., Jimenez, AD., et al.[2023]

In a study of 463 rural drug users in Appalachia, 28% had a history of overdose, and 57% were connected to someone who had overdosed, highlighting the widespread risk within social networks.

Targeting individuals who are geographically central and have previously participated in alcohol detox programs for overdose prevention training could enhance the effectiveness of interventions and potentially reduce overdose fatalities in the region.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Network and Spatial Data to Better Target Overdose Prevention Strategies in Rural Appalachia. Rudolph, AE., Young, AM., Havens, JR.[2020]

A study involving 200 interviews with people who inject drugs revealed that a small core group of 63 individuals, identified as 'harm reduction champions', was crucial in reaching about 70% of their harm reduction network.

The research highlighted the importance of not only these champions but also 'articulation points'—31 individuals who, while less connected, were effective in reaching those on the periphery of the network, suggesting a strategic approach to enhance harm reduction interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Back to the core: A network approach to bolster harm reduction among persons who inject drugs. Bouchard, M., Hashimi, S., Tsai, K., et al.[2018]

Community-based overdose prevention programs, which include naloxone distribution and overdose education, have become the leading public health intervention for preventing opioid overdoses since their emergence in the 1990s.

Current challenges in the opioid crisis, particularly with synthetic opioids like fentanyl, may affect the efficacy of standard naloxone formulations, highlighting the need for updated strategies in naloxone programming and overdose response.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic. Fairbairn, N., Coffin, PO., Walley, AY.[2019]

In a study involving 25 individuals who knew someone who overdosed, responses varied widely; some increased their drug use to cope with grief, while others reduced their use due to heightened overdose awareness.

The results highlight the importance of developing network-based overdose prevention strategies and integrating mental health support for individuals affected by overdose in their social circles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Drug use behaviors, trauma, and emotional affect following the overdose of a social network member: A qualitative investigation. Macmadu, A., Frueh, L., Collins, AB., et al.[2023]

Citations

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Social Network Overdose Prevention and Education ...

The purpose of this study is to test a social intervention focused on overdose prevention and care. In the investigators prior work, the investigators have ...

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Social Network Overdose Prevention and Education ...

The purpose of this study is to test a social intervention focused on overdose prevention and care. In the investigators prior work, the ...

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Public Health Interventions and Overdose-Related ...

This decision analytical model estimates the projected 3-year association between public health interventions and opioid overdose-related outcomes

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Study assessing the effectiveness of overdose prevention ...

At the individual level, we assess whether a cohort of 500 persons utilizing OPCs experience lower rates of overdose, other health problems ( ...

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California Overdose Prevention Network

COPN offers a monthly series of free webinars, workshops, and guided discussions to support local leaders in effective coalition building and overdose ...

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Overdose Prevention and Response Toolkit

SAMHSA's updated Overdose Prevention and Response Toolkit provides guidance to a wide range of individuals on preventing and responding to an overdose.

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nopn.org

nopn.org/california

California Overdose Prevention Network - Home

Our multi-sector coalitions reach 85% of Californians with life-saving interventions, education, and resources to address drug addiction and overdose. Our ...