Objective: This study describes the implementation and evaluation of revised opioid overdose prevention and education of naloxone training for law enforcement officers (LEOs) that added: (1) a recovery testimony and (2) the process for deputy-initiated referrals postnaloxone administration. Design and Sample:Evaluation regarding the naloxone training included a pre-and postopioid overdose knowledge surveys (N = 114) and subsequent 1-year postnaloxone training outcomes.Results: Pre-and posttest scores for all knowledge outcome measures were statistically significant (p < .001) with favorable comments pertaining to the recovery testimony. Out of 31 individuals who received naloxone, 6 individuals (19.4%) continue to be in treatment or received some treatment services. The most common symptoms reported were unconsciousness/unresponsiveness (40.5%), abnormal breathing patterns (24.3%), and blue lips (16.2%). The majority of the calls (65.6%) were to a residential area, and the time for naloxone revival ranged <1-10 min (M = 3.48; SD = 2.27). Conclusion:As nearly 20% of individuals sought treatment after a LEO-initiated referral, it is recommended that other agencies consider the referral process into the training. Future research will investigate the impact of the recovery testimony in reducing the stigma of addiction. K E Y W O R D Sevaluation, law enforcement officers, naloxone, opioid overdose prevention and education | BACKGROUNDDeaths due to opioid overdoses have reached epidemic proportions in the United States. Much of the rise in opioid overdose fatalities has been due to deaths from prescription opioid pain killers combined with a sharp rise in deaths related to heroin and synthetic opioid pain relievers other than methadone (Rudd, Aleshire, Zibbell, & Gladden, 2016). Deaths from opioid overdose occur via respiratory depression, occur minutes to hours after opioid ingestion (Sporer, 2003; Zador, Sunjic, & Darke,1996), and are witnessed by others Paulozzi, 2012). Therefore, opportunities exist for prevention and intervention. One key antidote to reverse opioid overdoses is naloxone hydrochloride. Naloxone is a pure opioid antagonist, reversing the respiratory depression caused by opioids, and has been used by medical personnel for more than 40 years (Wermeling, 2015). It is a nonscheduled drug that comes in a variety of formulations (intravenous, intramuscular, subcutaneous, and intranasal [IN]), has no effect if no opioids are in the body, lasts for 30-81 min, and has no potential for abuse (Darke & Hall, 1997).With increasing rates of opioid overdose mortality, one method to prevent opioid overdose-related deaths has been the implementation of community-wide initiatives and trainings to increase access In response, the Washtenaw County Office (WCO) implemented naloxone training for its LEOs in August 2015. The purpose of this descriptive study was twofold. We will describe the implementation of LEO naloxone training that added two topics to the standard naloxone education curriculum: (1) a recove...

Background Effective interventions for overdose survivors are needed in the emergency departments (EDs). One promising model is the use of peer recovery coaches to engage with survivors in EDs, followed by partnering with community case management navigators to connect survivors to recovery support and treatment services. This paper describes the evaluation of a pilot program, the Recovery Opioid Overdose Team (ROOT), a warm hand-off system that links survivors to treatment services post-ED discharge. Methods The ROOT program is composed of a peer recovery coach who is in long-term recovery, and a case management navigator who specializes in mental health care and provides guidance for accessing community services. After an overdose reversal, law enforcement contacts a county 24/7 Crisis Team, who then notifies ROOT. The peer recovery coach engages with the survivor in the ED, and then follow up continues with the case management navigator and the peer recovery coach for up to 90 days post-ED discharge. Retrospective chart reviews were conducted to evaluate ROOT in two Midwest EDs from September 2017 through March 2019. Results Of the 122 referrals, 77.0% ( n = 94) of the survivors initially engaged with ROOT in the ED or in the community. The remaining 23.0% ( n = 28) left the ED against medical advice or were unengaged. The majority of overdose survivors were male (63.9%; n = 78), White (43.4%; n = 53), had housing (80.2%; n = 48), and access to transportation (48.4%; n = 59). From the 122 referrals, 33.6% ( n = 41) received ongoing treatment services ( n = 20 outpatient, n = 17 residential, n = 2 detoxification facility, n = 1 recovery housing, n = 1 medication treatment for opioid use disorder), 2.5% ( n = 3) were incarcerated, 2.5% ( n = 3) died, and 61.5% ( n = 75) declined services. Conclusions The ROOT, a community-wide coordinated program in the EDs, shows promise in linking overdose survivors to recovery support and treatment services post-overdose.