1. Opioid Overdose Prevention with Naloxone an Adjunct to Basic Life Support Training for First Year Medical Students Noah Berland MS3 MS †, Babak Tofighi MD †#, Aaron Fox MD MS, and Kathleen Hanley MD †‡# † New York University School of Medicine Albert Einstein College of Medicine, Division of General Internal Medicine ‡ Department of Medicine # Department of Population Health

2. Disclosure None of the Authors have any Conflicts to Disclose 2

3. New York University SOM and Bellevue Hospital Center 3

4. Current Landscape Deaths attributed to opioid analgesics have more than quadrupled since 1999 1 Community based Opioid Overdose Prevention Programs have been successful and cost-effective 2 Medical education does not adequately address substance use disorders, including opioid OD 3 4 1.QuickStats: Rates* of Deaths from Drug Poisoning † and Drug Poisoning Involving Opioid AnalCDC Vital Signs, Opioid Painkiller Prescribing, July 2014 2.Coffin PO, Sullivan SD. Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. Ann Intern Med. 2013;158(1):1-9. 3.CASA Columbia Report on Addiction Treatment, 2012

5. Objectives Increase student Knowledge relating to Opioid Overdoses Make students feel more Prepared to manage an individual overdosing on opioids Improve student Attitudes towards patients with substance use disorders 5

6. The Intervention 6 Pre-Test Made Available Naloxone, Signs, Symptoms, Risk Factors for OD How Respond to an OD Teach Back Post-Test and Training Feedback Standard BLS Training The Training

7. Evaluation Instrument Demographics and a Unique Identifier Attitudes: 11 question, 6 point Validated Likert Scale 1 Knowledge test: 16 multiple choice questions 2 Preparedness: 14 Question, 5 point Validated Likert Scale 2 7 1.Christison GW, Haviland MG, Riggs ML. The medical condition regard scale: measuring reactions to diagnoses. Acad Med. 2002;77(3):257-262. http://www.ncbi.nlm.nih.gov/pubmed/11891166. 2.Williams A V, Strang J, Marsden J. Development of Opioid Overdose Knowledge (OOKS) and Attitudes (OOAS) Scales for take-home naloxone training evaluation. Drug Alcohol Depend. 2013;132(1-2):383-386. doi:10.1016/j.drugalcdep.2013.02.007.

8. Analysis Unique Identifiers used to pair pre-Test and post- Tests for paired T-Tests Incomplete and unpaired entries were excluded Questions with very high rates of correct responses on pre-Test were excluded Controlled for individuals whom had past training 8

9. Demographics 9 MeasureSurvey NSurvey %Admissions NAdmissions % Total73149 Male3547.98355.7 Female3852.16644.3 Age Age<234156.28355.7 22<Age<252635.65436.2 Age>2468.2128.1 Asian2838.45134.2 Black00.032.0 White3446.67147.7 Other1115.12416.1

10. Results: Knowledge 10 *Statistically Significant p<0.05

11. Results: Preparedness 11 *Statistically Significant p<0.05

12. Results: Attitudes 12

13. Feedback 13 MeasureN% Agree Enjoyed the Training4795.7 Future Classes Should be Trained4797.9 Pre Training Survey Helped*3974.4 Post Training Survey Helped*4793.6 *Helped in understanding of Opioid Overdose Prevention

14. Conclusions Integrating OOP training into BLS for MS1s increases preparedness and knowledge OOP training does not acutely change attitudes towards individuals with SUDs Students enjoyed the training and believe that other medical students should receive the training 14

15. Next Steps Test for durability of training longitudinally New Knowledge instrument targeting providers Compare class of 2018 with class of 2017 Expand training to other institutions Integration of Naloxone education into AHA BLS Web-based Training module to aid expansion and sustainability 15

16. Acknowledgements Inspiration: Dova Marder MD Training Help: Andrew Hallett MS3, Ben Suwing, and the NYU Department of Emergency Medicine Statistical Assistance: Keith Goldfeld DrPH Consultation: Joshua Lee MD MS Thanks: Lisa Wang MS3 and Patrick Malecha MS3 Funding: SARET Program, NIDA-R25 DA022461 16

17. Questions? 17