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Web applications for training in the
use of naloxone nasal spray to
prevent opioid overdoses
Desiree Madah-Amiri, PhD
Norwegian Centre for Addiction Research
LAR conference, October 2018
Background
• What is naloxone?
• What is take home naloxone?
• How has it been implemented in Norway
• Why the need for web applications?
• What digital platforms are now being used
Naloxone
• Antidote to an opioid overdose
• Take-home naloxone
– administered before ambulance arrives
• Training
– Prevention, recognition, response
Take-home naloxone in Norway
National overdose prevention strategy in 2014
– Pilot in Oslo & Bergen
– Funding provided
– Prescription-free
– Intranasal device
57
8 74
4 9
80
13
46
15
1
58
3 80
3
11
83
72
9
13
27
17
83
25
29
2014 2015 2016 2017
INITIAL AND REFILL NALOXONE DISTRIBUTED 2014-2017
Initial Refill Total
By first quarter 2018: 7000
Distribution centers
100 different distribution sites throughout 29 municipalities
Expansion
15 new in 2018
Over 29 municipalities
75% coverage of OD locations
2018
Fredrikstad
Bodø
Tromsø
Skien
Porsgrund
Tønsberg
Arendal
2017
Drammen
Asker
Stavanger
Sandnes
Trondheim
2016
Oslo
Bergen
2014
• Expansion meant needing to re-evaluate
how we were operating
• Current methods somewhat unsustainable
Training
User
5-10 minutes
Risk factors
Prevention
Recognition
Response
Staff
2 hours
Staff able to then train users
Staff training
Staff from existing low-threshold centers
• Train-the-trainer model
– Began with 3 central trainers
– >500 staff trained in first 18 months
– Currently over 1200
Madah-Amiri, Clausen, & Lobmaier. Drug alcohol depend. 2016
While successful, not sustainable…
…Naloxone had to modernize and adapt
E-learning
E-learning
Background
• Overdoses
• Naloxone program
• Opioids
• Naloxone
Curriculum
• Risk factors
• Recognition
• Response
• HLR
Documentation
• Initial forms
• Refill forms
• Nettskjema
Other
• Debriefing
• Considerations
• Ideas for implemntation
Questions throughout, final quiz, certification
Online data collection
Training
User
5-10 minutes
Risk factors
Prevention
Recognition
Response
Staff
2 hours
Staff able to then train users
www.stoppoverdose.no
Acknowledgements Naloxone ninjas
Åse Merete Solheim (Bergen)
Øystein Bruun Ericson (Oslo)
Vibeke Kleveland (Trondheim)
Julie Høivik
SERAF
Philipp Lobmaier (MD, PhD)
Thomas Clausen (professor, PI)
Pharmaceutical industry (DnE)
Jenny Teigene and colleagues
Directorate of Health
Martin Blindheim
Ambulance services
Guttorm Brattebø (Bergen), Arne Skulberg (Oslo), and colleagues
