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Vermont Opioid Overdose Prevention and Reversal Project

A statewide overdose prevention system includes a EMS leave-behind naloxone program that has been found to increase naloxone distribution to high-risk populations

Naloxone can reverse opioid overdoses but is often not immediately available, especially in rural areas. To help close the gap in naloxone availability, Vermont initiated its statewide Opioid Overdose Prevention and Reversal Project (OOPRP). The Vermont Department of Health provides naloxone and training through collaborations with community-based organizations. These partners distribute naloxone rescue kits and provide overdose response training, opioid misuse prevention training, and referrals to treatment across Vermont. The program's website provides videos on how to recognize an overdose, how to administer naloxone, and a map of where to find it in the state. This OOPRP data brief gives an overview of program utilization and outcomes.

A unique feature of OOPRP is the "Naloxone Leave Behind" program (preliminary evaluations are here and here) which requires emergency medical services (EMS) workers to identify patients at risk for an overdose and provide them with naloxone if they refuse transport to a hospital after a nonfatal overdose. Presentations describing the operations and outcomes of this program are here and here, and the procedure for dispensing naloxone rescue kits is described in section 8.11 of the Vermont Statewide EMS Protocols. Contact information for the program can be found at the OOPRP website.

Opioid Overdose Prevention and Reversal targets life-saving services to people who are using drugs, family members, and others that may be in a position to help in the event of an opioid overdose. 

Continuum of Care
Harm Reduction
Type of Evidence
Peer-reviewed
Response Approach
Overdose prevention
Post-overdose response
Peer-reviewed Article
At-risk patient documentation and naloxone dispersal for a rural statewide EMS “Naloxone Leave Behind” program
Preliminary Analysis of Vermont's EMS Naloxone Leave-Behind Program
Related Resources
A Systematic Review of Community Opioid Overdose Prevention and Naloxone Distribution Programs
Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States
Legal Interventions to Reduce Overdose Mortality: Naloxone Access and Overdose Good Samaritan Laws
One Opioid User Saving Another: The First Study of an Opioid Overdose-Reversal and Naloxone Distribution Program Addressing Hard-to-Reach Drug Scenes in Denmark
Opioid Safety: Focus on Furnishing Naloxone
Guide to Developing and Managing Overdose Prevention and Take-Home Naloxone Projects
Preventing Opioid Overdose Deaths with Take-Home Naloxone
SAMHSA Opioid Overdose Prevention Toolkit
dsu-naloxone-ems-quarterly.pdf

Evidence of Program Effectiveness

 "[T]his preliminary data review shows that EMS providers are sufficiently able to quickly identify patients at high-risk of opiate overdose, and also effectively able to offer and provide a life-saving naloxone kit when they are otherwise unable to encourage these patients to seek further treatment at a hospital. The high acceptance rate of naloxone leave-behind kits shows that patients also recognize the importance of having a kit on-hand should unintended overdose occur. The demographics (ages 30-49, male gender) of the high-risk patients also reflect the demographics of the patients who experience fatal overdose in Vermont throughout 2020, indicating that this program effectively reaches the target population of Vermonters at highest risk of dying by overdose." - S. Bissonette, 2021.