Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: a pilot randomized controlled trial.

Coffin, Phillip Oliver; Santos, Glenn-Milo; Matheson, Tim; Behar, Emily; Rowe, Chris; Rubin, Talia; Silvis, Janelle; Vittinghoff, Eric

doi:10.1371/journal.pone.0183354

Cited by 44Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesHIV, Drug Use, Sexual Risk

Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: a pilot randomized controlled trial.

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Coffin, Phillip Oliver, Santos, Glenn-Milo, Matheson, Tim, Behar, Emily, Rowe, Chris, Rubin, Talia, Silvis, Janelle, Vittinghoff, Eric·2017·PLoS ONE

DOI 10.1371/journal.pone.0183354PMC PMC5648110

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Abstract

OBJECTIVE: The United States is amidst an opioid epidemic, including synthetic opioids that may result in rapid death, leaving minimal opportunity for bystander rescue. We pilot tested a behavioral intervention to reduce the occurrence of opioid overdose among opioid dependent persons at high-risk for subsequent overdose. MATERIALS AND METHODS: We conducted a single-blinded randomized-controlled trial of a repeated dose motivational interviewing intervention (REBOOT) to reduce overdose versus treatment as usual, defined as information and referrals, over 16 months at the San Francisco Department of Public Health from 2014-2016. Participants were 18-65 years of age, had opioid use disorder by Structured Clinical Interview, active opioid use, opioid overdose within 5 years, and prior receipt of naloxone kits. The intervention was administered at months 0, 4, 8, and 12, preceded by the assessment which was also administered at month 16. Dual primary outcomes were any overdose event and number of events, collected by computer-assisted personal interview, as well as any fatal overdose events per vital records. RESULTS: A total of 78 persons were screened and 63 enrolled. Mean age was 43 years, 67% were born male, 65% White, 17% African-American, and 14% Latino. Ninety-two percent of visits and 93% of counseling sessions were completed. At baseline, 33.3% of participants had experienced an overdose in the past four months, with a similar mean number of overdoses in both arms (p = 0.95); 29% overdosed during follow-up. By intention-to-treat, participants assigned to REBOOT were less likely to experience any overdose (incidence rate ratio [IRR] 0.62 [95%CI 0.41-0.92, p = 0.019) and experienced fewer overdose events (IRR 0.46, 95%CI 0.24-0.90, p = 0.023), findings that were robust to sensitivity analyses. There were no differences between arms in days of opioid use, substance use treatment, or naloxone carriage. CONCLUSIONS: REBOOT reduced the occurrence of any opioid overdose and the number of overdoses. TRIAL REGISTRATION: clinicaltrials.gov NCT02093559.

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[62]Coffin PO, Sullivan SD. Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. Ann Intern Med. 2013; 158(1): 1– 9. doi: 10.7326/0003-4819-158-1-201301010-00003. 23277895 · DOI

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Authors: Coffin, P. O., Santos, G.-M., Matheson, T., Behar, E., Rowe, C., Rubin, T., Silvis, J., & Vittinghoff, E.
Affiliations: University of California, San Francisco (US)
San Francisco Department of Public Health (US)
Corresponding author: Coffin, Phillip Oliver
ORCID: Coffin, Phillip Oliver
Santos, Glenn-Milo
Matheson, Tim
Behar, Emily
Vittinghoff, Eric
Venue: PLoS ONE
Publisher: Public Library of Science (PLoS)
Published: 2017-10-19
Volume: 12
Issue: 10
Pages: e0183354
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0183354
PMC: PMC5648110
OpenAlex: W2767186288
Cited by: 44
References: 64
Citations by year: 2026: 2 · 2025: 2 · 2024: 3 · 2023: 9 · 2022: 6 · 2021: 4 · 2020: 7 · 2019: 8 · 2018: 3
FWCI: 4.61
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: PLoS ONE (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
eScholarship (California Digital Library) (submittedVersion)
eScholarship (California Digital Library) (submittedVersion, cc-by)
Figshare (submittedVersion, cc-by)
Funders: National Institute on Drug Abuse (R34DA037194)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords: opioid overdose, opioid use disorder, motivational interviewing, behavioral interventions, naloxone, synthetic opioids, overdose prevention, high-risk individuals, opioid epidemic
MeSH terms: Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Narcotic Antagonists, Opioid-Related Disorders, Pilot Projects, Risk Factors, Single-Blind Method, Treatment Outcome, Young Adult, Drug Overdose

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Behavioral intervention to reduce opioid overdose among high-risk persons with opioid use disorder: a pilot randomized controlled trial.

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