Evidence map›Paper›PMID 39786790›Full record

Trial reportPrehospital emergency care2025

Approaches, Barriers, and Facilitators in Statewide Initiative to Combat Opioid Overdose: A Narrative Review of Ohio's Experiences During the HEALing Communities Study.

Jason McMullan, Will Mueller, Jennifer L Brown, Irene Ewing, Michael S Lyons, Joel Sprunger, John Winhusen, Thomas Collins

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Prehospital emergency care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Assessment of a County-Wide, Pan-First Responder Take-Home Naloxone Program in Denver, Colorado.Journal of the American College of Emergency Physicians open · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jason McMullanDepartment of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.ORCID 0000-0002-7656-7447
Will MuellerColerain Township Fire Department, Colerain, Ohio.
Jennifer L BrownDepartment of Psychological Sciences, Purdue University, West Lafayette, Indiana.
Irene EwingDepartment of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Michael S LyonsDepartment of Emergency Medicine, College of Medicine, The Ohio State University, Columbus, Ohio.
Joel SprungerDepartment of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio.
John WinhusenDepartment of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Thomas CollinsDepartment of Emergency Medicine, MetroHealth Medical Center, Cleveland, Ohio.

Funding

Optimizing HEALing in Ohio Communities (OHiO)-Health Equity SupplementUM1DA049417 · NIDA · OHIO STATE UNIVERSITY · PI FREISTHLER, BRIDGET J, WINHUSEN, T JOHN · 2019 to 2023
$66.3M
NIDA NIH HHS UM1 DA049417
6 · The paper itself

Abstract

objectivesOpioid-associated fatal and non-fatal overdose rates continue to rise. Prehospital overdose education and naloxone distribution (OEND) programs are attractive harm-reduction strategies, as patients who are not transported by EMS after receiving naloxone have limited access to other interventions. This narrative summary describes our experiences with prehospital implementation of evidence-based OEND practices across Ohio as part of the HEALing Communities Study (HCS).

methodsHCS was a parallel-group, cluster randomized, unblinded, wait-list controlled trial of 67 communities highly impacted by opioid-related overdose fatalities in four states, including Ohio. An EMS Intervention Design Team (IDT), consisting of EMS physicians, paramedics, and an EMS department Chief with an established OEND program, supported participating EMS agencies. Services of the IDT included protocol development, program training, and stigma-reduction education. HCS funding supported implementation costs and varied by county/agency.

resultsIn 12 Ohio counties, 29 agencies implemented an OEND program; agencies served rural, suburban, and urban communities. While leaving naloxone kits with patients and/or families at an EMS call was universally adopted, additional OEND approaches were undertaken. Seven EMS agencies registered with the Ohio Department of Health's Project DAWN program, allowing hub-and-spoke distribution of state-provided naloxone to smaller OEND programs. An urban EMS agency targeted mass gatherings for OEND efforts; bicycle teams providing crowd medical response distributed leave-behind naloxone kits in a process mirroring traditional 9-1-1 calls while static first aid stations offered overdose educational materials, information on local resources, and take-home naloxone kits. A rural EMS agency allowed community members to request naloxone kits from agency headquarters. To address an overdose hotspot at an interstate rest area, a rural joint ambulance district partnered with the county health department to install and maintain a public-access naloxone station. Observed facilitators included Ohio's legal and regulatory environment, creating local definitions of success, identifying and empowering local champions, and operational solutions to ease OEND for practitioners. Stigma represents the biggest barrier, with ongoing education as the best solution. Incremental program implementation was most successful.

conclusionsOur OEND implementation experiences across multiple Ohio EMS agencies identified several barriers, facilitators, and creative solutions that may inform future prehospital harm-reduction programs.

Indexed as

Drug OverdoseEmergency Medical ServicesNaloxoneNarcotic AntagonistsOpiate OverdoseHarm ReductionHumansOhioNaloxoneNarcotic Antagonists

Identifiers

PMID39786790
PMCPMC12910609

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.