Catching Us When We Fall: A Rapid Evaluation of the Non-Fatal Overdose Response in Dundee, Scotland

Background
Opioid-related deaths continue to take the lives of hundreds in Scotland each year, with non-fatal overdose (NFOD) as a significant risk factors for repeat non-fatal and fatal overdoses. Evidence suggests that individuals who survived a recent life-threatening overdose might be more likely to initiate and continue with treatment if they are approached and presented with the right opportunities. In Dundee, Scotland, the Non-Fatal Overdose Response was established in November 2019 to provide an acute, immediate action to those who have experienced an NFOD. The purpose of this evaluation was to evaluate the current Response and examine how this provides the best care arrangements to meet needs.

 Methods
The reviewers undertook a rapid review of the peer-reviewed literature to identify and assess the feasibility, acceptability, and effectiveness of post-overdose interventions. They also gathered insights from an online survey with 25 key stakeholders and telephone interviews with 12 delivery staff and 5 governance staff. Interviews were transcribed, coded, and analysed using thematic analysis.

 Results
The review found that the Response has particular success in its speed, efficiency, effectiveness, coordination and communication, and partnership working. The reviewers have made best-practice recommendations around improving data collection, recording, and sharing; improving measuring, monitoring, and reporting outcomes and feedback; ensuring sustainability, resources, and funding; improving and adding links with other services; promoting a more proactive/preventative approach; and ensuring clear and explicit accountability. Further quantitative and quality improvement research including those who have experienced an NFOD is warranted.