Theme: Epidemiology & Public Health Research Year: 2025
| Background: When opioid use is solitary or unmonitored, there is likely no bystander present to administer naloxone, call for help, or provide support. Solitary, unmonitored and monitored drug use are typically not reported. We aimed to describe the frequency of solitary, unmonitored, and monitored opioid use at non-fatal overdoses.
Methods: We analyzed data collected during the REBOOT 2.0 randomized controlled trial. Between April 2019 and April 2022, overdose survivors from San Francisco and Boston who were using opioids completed up to 5 assessments over 16 months. Each assessment asked about up to 3 overdoses experienced in the last 4 months: “Which of these options best describes who you were with when this overdose event occurred?” Options included i) No one (I was alone) ii) Within view of strangers who were not actively monitoring me, iii) With others that I know who were not monitoring me, and iv) Monitored by others. We categorized i as Solitary, ii and iii as Unmonitored and iv as Monitored. Results: Among 268 REBOOT participants, 382 non-fatal overdoses were reported. Of these 45% (174) were Monitored, 36% (139) were Unmonitored and 18% (69) were Solitary. Solitary overdose survivors commonly received naloxone from a trained professional (35%), whereas Unmonitored and Monitored survivors received naloxone most often from a bystander only (48% and 62%, respectively). Emergency responders came to 48% of Solitary, 55% of Unmonitored and 39% of Monitored overdoses. These responders transported to hospital 46% of Solitary, 37% of Unmonitored, and 26% of Monitored overdoses. Conclusion: Among overdose survivors in San Francisco and Boston, solitary, unmonitored, and monitored drug use were all common. Monitored overdose survivors were more likely to receive naloxone from a bystander and less likely to be transported to hospital. Research measuring solitary and unmonitored drug use is important to making drug use safer and reducing fatal overdose. |