P3.009: Enhancing Naloxone Access in High-Risk Youth Through Targeted Practitioner Education

Purpose/Objectives: Opioid-related death is significantly rising across all demographics, with alarming increase in adolescent populations. CDC recommends offering naloxone to at-risk individuals, but its use remains low in adolescents. The Los Angeles County Medical Hub Clinics serve youth in the child-welfare system, with Violence-Intervention-Program (VIP) being the largest. It is unclear how often adolescents in VIP receive naloxone. This project aims to increase naloxone access for at-risk youth seen at VIP and improve provider education on its prescription and use.

Design/Methods: Project’s initial steps involved dispersing a questionnaire evaluating provider comfort and previous experience with prescribing naloxone. For intervention, we provided educational seminars for practitioners and placed naloxone advertisement posters in patient rooms. Pre- and post-education data determined whether practitioners reported an increase in naloxone prescriptions or counseling. We also examined practitioner knowledge of naloxone pre- and post-education. Criteria for naloxone prescription was modified from CDC recommendations. We assessed four different time points (months), two pre-distribution and two post-distribution. Assessed patients ages 12-21 who presented for medical clearance, forensic exams, child abuse consultation, or sexual assault evidence collection to determine qualified individuals and to determine if prescriptions and counseling had increased (pre-education: December 2022, January 2023; post- education: December 2023, January 2024). Data analyzed using 2-side Fisher Exact Test and One-way Anova.

Results: Prior to intervention, only 1 of 8 surveyed practitioners had prescribed naloxone and only 5 of 8 responding practitioners had educated a patient about naloxone's use. During this project, total number of visits during pre-education months was n=310 and during post- education months was n=278. Number of individuals who qualified for naloxone prescription pre-intervention was n= 56 and post-intervention was n=58. Number of qualified patients who had received naloxone (pre-education n= 1 and post-education n=11).
Following practitioner education, 64% increase of practitioners reported prescribing naloxone pre- and post-education (p = 0.0075). Percent of practitioners who reported providing naloxone counseling also increased by 9% (p = >0.5).
Number and percent of qualifying patients did not vary per month (p = >0.5). Number of patients who received or were offered naloxone increased significantly (pre-education: 0.00% in December 2022, 5.00% in January 2023; post-education: 24.14% in December 2023, 13.79% in January 2024; p = 0.01).
17.2% increase in naloxone prescriptions amongst qualifying patients post-intervention.
60% of responding practitioners reported patients inquiring about naloxone after posters were placed in patient rooms.

Conclusion/Discussion: Following provider education, naloxone prescriptions and practitioner prescribing rates rose significantly. Patient inquiries about naloxone increased after informational posters were placed in exam rooms. Additionally, knowledge assessments showed sustained improvement in practitioner understanding. However, our data likely underestimates actual naloxone distribution, as free kits provided post-intervention were not tracked. Given that 80% of practitioners requested further training, expanding provider education remains a priority.