Phillip & crew- This is great- I particularly love your incentive structure! I wonder if you could upload this maybe as a PDF that one could download than then be able to zoom in and read Table 1 contents, for example?
Maya, thanks for provoking us to make the blog better --- OPA is Blogger-based, which only accepts image files, but after your comment I set up a way for us to host other types of files. We'll get a PDF of the poster up soon.
I too dig the poster and will be happy to see it written up into a paper. Though I'd push back against how most people will interpret the title of the blog post --- that people who administer naloxone (or otherwise participate in a naloxone project) share less should be kind of unsurprising, because it's very likely that OD responders are people who are more likely to be more engaged with services. I wonder if that could be looked at in the (cross-sectional) data? Any measures that get at that, like having a case manager or drug counselor or volunteering?
Thanks for bringing that up, Matt. While I agree with you that people who respond to an OD with naloxone are likely more engaged with services, I've also come to believe that naloxone programs do more than result in OD reversals. I think behaviors change - perhaps including HIV risk behaviors. This is, of course, speculation for now.
No doubt about that, Phillip, based on both tons of firsthand experience for a lot of providers and strongly suggested by some of the modeling work that you and others have done. But we really need to see some Capital-E-Evidence for it.
One way someone could probably start to get at that with existing data is where naloxone distribution is linked to syringe exchange anonymous IDs, which would by definition be linked to data about services participation. So you could look at that before/after involvement in a naloxone project. It's not behavioral outcomes per se, but there's other evidence that more participation = less risky behavior (isn't there?). Anyhow, just thinking out loud.
So interesting! I wonder if separating opt-in venues (like syringe exchange) from opt-out venues (like lock-up, detox, EDs) for providing overdose education/naloxone distribution might be an alternative/additional way of figuring out if safety maximizing behaviors are associated with naloxone programs in general or just among those who seek them out... Also, thanks for the new functionality!
Thanks for adding great info to the mix Coffins, Tom and Shilo! As well, getting this info to the Int AIDS Conference is critical and, as one person integrating HIV and OD work, I can say there are many strong reasons to integrate the two to create synergy!
Really interesting stuff, thanks for sharing. In Scotland, we are exploring the wider benefits of naloxone programmes including improved treatment engagement, reduced illicit drug use. We'll certainly add this in to the mix.
Phillip & crew- This is great- I particularly love your incentive structure! I wonder if you could upload this maybe as a PDF that one could download than then be able to zoom in and read Table 1 contents, for example?
ReplyDeleteMaya, thanks for provoking us to make the blog better --- OPA is Blogger-based, which only accepts image files, but after your comment I set up a way for us to host other types of files. We'll get a PDF of the poster up soon.
ReplyDeleteI too dig the poster and will be happy to see it written up into a paper. Though I'd push back against how most people will interpret the title of the blog post --- that people who administer naloxone (or otherwise participate in a naloxone project) share less should be kind of unsurprising, because it's very likely that OD responders are people who are more likely to be more engaged with services. I wonder if that could be looked at in the (cross-sectional) data? Any measures that get at that, like having a case manager or drug counselor or volunteering?
Thanks for bringing that up, Matt. While I agree with you that people who respond to an OD with naloxone are likely more engaged with services, I've also come to believe that naloxone programs do more than result in OD reversals. I think behaviors change - perhaps including HIV risk behaviors. This is, of course, speculation for now.
ReplyDeleteNo doubt about that, Phillip, based on both tons of firsthand experience for a lot of providers and strongly suggested by some of the modeling work that you and others have done. But we really need to see some Capital-E-Evidence for it.
DeleteOne way someone could probably start to get at that with existing data is where naloxone distribution is linked to syringe exchange anonymous IDs, which would by definition be linked to data about services participation. So you could look at that before/after involvement in a naloxone project. It's not behavioral outcomes per se, but there's other evidence that more participation = less risky behavior (isn't there?). Anyhow, just thinking out loud.
So interesting! I wonder if separating opt-in venues (like syringe exchange) from opt-out venues (like lock-up, detox, EDs) for providing overdose education/naloxone distribution might be an alternative/additional way of figuring out if safety maximizing behaviors are associated with naloxone programs in general or just among those who seek them out...
ReplyDeleteAlso, thanks for the new functionality!
Thanks for adding great info to the mix Coffins, Tom and Shilo! As well, getting this info to the Int AIDS Conference is critical and, as one person integrating HIV and OD work, I can say there are many strong reasons to integrate the two to create synergy!
ReplyDeleteReally interesting stuff, thanks for sharing. In Scotland, we are exploring the wider benefits of naloxone programmes including improved treatment engagement, reduced illicit drug use. We'll certainly add this in to the mix.
ReplyDelete