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Surviving Opioid Overdose with Naloxone Education and Resuscitation (SOONER)

PI and project team: Rehm, J., Charters, D., & Strike, C. 

The goal of this project is to design and evaluate a novel overdose education and naloxone distribution toolkit for clinical settings. The project has three phases. In phase one, a naloxone distribution and training toolkit for open-access distribution was co-designed in collaboration with St. Michael's Hospital and the Ontario College of Art and Design (OCAD) University. Phase two involved feasibility trials to establish recruitment and retention strategies for a full-scale RCT. During phase three (the RCT phase), people likely to witness overdose will be recruited in emergency department, family practice, and addictions medicine settings and randomized to either the novel naloxone training kit and tool, or existing community-based standard of care. The primary outcome will be satisfactory bystander first aid in a simulated opioid overdose scenario, conducted within two weeks of recruitment.  

Successes and Opportunities:

  • The SOONER Feasibility study demonstrated project feasibility in addictions medicine, family practice, and ED settings.  This shows that a simulation-based RCT is logistically feasible.  The feasibility study is published in Resuscitation Plus and the associated protocol is published in BMJOpen.

  • The SOONER Feasibility study also offers a replicable model for recruiting and retaining people who use drugs and who are likely to witness opioid overdose in a RCT.  This is an independent innovation that can serve the research community and CRISM nationally and internationally.

  • Manuscripts concerning the SOONER simulation model, and the outcomes of the SOONER co-design research are complete and under peer review.

  • Although COVID-19 has generated many challenging disruptions for SOONER, the need for brief point-of-care naloxone distribution tools is more acute than before.  Quite unexpectedly, COVID-19 has made the SOONER training tools more applicable than before.  A number of community stakeholders are interested in implementing the tool in practice and we plan to pursue this implementation and KT opportunity.