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MAYA DOE-SIMKINS: The time period post overdose
is a really key and important time.
There's a lot of things that we can
do to be helpful and supportive at the moment of overdose
and following overdose.
We also need to be really careful about the way
that we craft those interventions.
So when somebody overdoses, their immediate safety
and survival has to be addressed.
So that's one thing.
Sometimes when people overdose, this
is the opportunity to talk about treatment, or to offer access,
like supported access to get people into treatment.
And sometimes it's not.
Quite honestly, an overdose is an absolute emergency.
It is scary.
It's uncomfortable.
People are freaked out.
And sometimes at that moment, people's priorities
are not necessarily talking about getting into treatment.
So in that sense, we need to be careful about how
what we expect this post overdose moment to be.
One of the things that is really helpful
is to take the opportunity to make a connection.
Everything about this opioid crisis is about connection.
So make a connection with someone
that either at that moment the person is like yes,
please help me get into buprenorphine treatment,
and then we can think about things
like emergency department based initiations
of buprenorphine or other strategies along--
you know, assisted referrals to treatment,
that there are great models all over the country.
When we're thinking about prevention--
because one of the strongest indicators
of dying of an overdose is having experienced
a previous non-fatal overdose.
So this is really important.
There's a study out of Massachusetts
that said that 10% of people who experience a non-fatal overdose
will be dead within two years of that first overdose.
That's jarring.
1 in 10.
So this non-fatal overdose is a really important opportunity
to think about inserting prevention strategies that we
know work.
So we want to s connection to people.
And if that connection doesn't result
in an immediate assisted referral to treatment
or connection to treatment, then that connection
should be with the person, that the person who
experienced the overdose can develop an ongoing relationship
with.
So it means that those services have
to be reliable, believable, trustworthy, and actually offer
the person who uses drugs something that they want.
People have to opt in to wanting this ongoing connection
with someone post overdose.
So these are things like needle exchanges, Naloxone access
programs, other services like housing or insurance.
And in that way, where we build a relationship that's
ongoing with people, then we are ready and poised
to be supporting folks to access the treatment when they're
ready, on their timeline.
We need to be careful about the notion of mandated treatment.
We need to ensure--
it has to go back to connection matters,
and people have to opt into this ongoing interaction.
So when we think of post overdose initiatives,
we have to think about it with some patience,
and we have to think about it as an opportunity to establish
a relationship that's ongoing.
There are some beautiful pilots in different parts
of the country where there is a three-day post overdose follow
up at the person's home consensually.
Show up and be like, just wanted to check in on you.
How are you doing?
How are you feeling?
How's your family doing?
Do you want to talk about overdose prevention?
Do you want to talk about naloxone?
Do you want to talk about anything else?
And so that's one way that we can envision a post overdose
prevention, intervention that would be enticing, respectful,
collaborative, and work on cementing
that connection between people who use drugs and services that
can help them survive.
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