Naloxone — SAIA

Between 1999 and 2020, the United States had more more than half a million opioid-related overdoses which resulted in death. The opioid overdose mortality epidemic disproportionately impacts Black, Indigenous, and people of color (BIPOC).

Naloxone Distribution in California

An estimated 2.2 million people in the United States (US) have an opioid use disorder, and less than 20% of them are currently receiving treatment. Opioid overdose fatalities are preventable with timely administration of the drug naloxone. Syringe service programs (SSPs) have pioneered naloxone distribution for potential bystanders of opioid overdose. SAIA-Naloxone includes (1) analyzing program data to identify gaps in the naloxone delivery cascade, (2) flow mapping to identify causes of attrition and brainstorm programmatic changes for improvement, and (3) conducting continuous quality improvement to test and assess whether modifications improve the cascade. Through SAIA-Naloxone, syringe service programs prioritize testing programmatic modifications to improve data collection procedures, proactively screen and identify naloxone-naïve participants, streamline naloxone refill systems, and allow for secondary naloxone distribution. A randomized controlled trial of SAIA-Naloxone’s will test its ability to improve naloxone distribution in general, and among BIPOC specifically. The trial will include 32 SSPs across California, randomly assigning 16 to the SAIA-Naloxone arm and 16 to receive implementation as usual. SSPs receiving SAIA-Naloxone will work with a SAIA coach for a period of 12 months. This trial takes a novel approach to improving equitable distribution of naloxone amid the ongoing epidemic and associated racial disparities. If successful, SAIA-Naloxone represents an important organizational-level solution to the multifaceted and multilevel barriers to equitable naloxone distribution.