Overdose response training and naloxone distribution among rural first responders.

In the midst of the overdose crisis, knowledge of overdose education and administration of naloxone, the opioid-overdose antidote, must expand outside emergency medical services (EMS)-based first responders, particularly in rural communities where police and fire departments often may arrive first on the scene to an overdose. Missouri has implemented a novel train-the-trainer model to increase the diffusion of overdose education and naloxone distribution to non-EMS first responders in rural communities. Training content was specifically developed to address first responders’ fears and reservations related to overdose response, which include but are not limited to personal risk of overdose from fentanyl exposure, belief in addiction as a moral failing, and lack of knowledge and resources to respond effectively to an overdose. Further, trainings also focused on the diffusion of naloxone-related legislation (i.e., Good Samaritan Laws, standing orders for naloxone) in Missouri to increase first responder awareness of relevant policies. Partnerships with local public health agencies allowed them to serve as hubs for naloxone distribution. This article describes the development and implementation of this project with the goal of promoting national replication to increase overdose education and access to naloxone for first responders in rural communities.