Identifying Areas of Need for Public Naloxone in Berks County, PA

CONTEXT: Substance use disorders (SUDs) pose a significant risk to public health. While there are plenty of resources out there, getting them to the right people presents a challenge. Medicaid expansion has been shown to be beneficial (Kravitz-Wirtz et al., 2020), and our public perceptions can negatively impact victims of SUDs. Furthermore, SUDs have contributed to nearly one-million deaths in the US since 1999 (NCDAS, 2022).

OBJECTIVE: To evaluate the impact of opioid use in Berks County, PA and assess the need for naloxone dispensing machines in areas of need (AON).

STUDY DESIGN AND ANALYSIS: This study is a needs assessment involving the Penn State Health St. Joseph Family Medicine Residency. We identified several community partners within Berks County, PA to gather information regarding the need for naloxone dispensing machines.

SETTING OR DATASET: Data was provided by Berks County on overdose (OD) death rates (Jan 2015-Dec 2021) and OD calls to 911 (Sept 2021-22) by location frequency. Additional information was obtained through interview with community partners involved with addiction treatment in Berks County.

POPULATION STUDIED: The general population of Berks County.

INTERVENTION/INSTRUMENT: Interpreting the data gathered to identify AON in Berks County.

OUTCOME MEASURES: Berks County AON based on OD rates and 911 OD call locations.

RESULTS: The Family Dollar at Penn St is the top location identified without naloxone at high risk for OD (9 fatal OD, 20 unconscious), with shopping centers being 31.67% of OD calls. Reading, PA totals over 50 OD calls, the next municipality less than 10. OD deaths per 100,000 Berks County residents by ethnicity (Jan 2015-Dec 2021) reveals that the White population OD rate increased from 19.0 to 34.1 while the Hispanic population OD rate increased from 17.3 to 40.2. The Black population OD rate peaked from 5.8 to 72.0 from 2015 to 2019 with a decline to 53.9 in 2020 and 2021.

CONCLUSIONS: Now that St. Joseph has completed the part of identifying local AON, the next steps are to work with partners and researchers at Penn State College of Medicine to design a separate study involving the installation of naloxone dispensing machines. This will help determine whether access to these machines would improve outcomes amidst the opioid crisis.