What is it about?

The opioid epidemic and associated fatalities remains at historically high levels, driven by fentanyl, xylazine and other adulterants used in street drugs. To reduce fatalities, opioid education and naloxone distribution (OEND) trainings have become more widespread. The Opioid Overdose Knowledge Scale (OOKS) has been developed to assess knowledge obtained during these trainings but has not been evaluated to see if it works equally well for assessing the training of bystanders (e.g., family members of a drug user, lay persons such as librarians, street drug users) and first responders (e.g., police, emergency medical services technicians). This study sought to make that determination.

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Why is it important?

Using rigorous statistical modeling, we found a shortened, 20-item version of the OOKs works equally well for bystanders and first responders being trained on recognizing an opioid-related overdose and administering naloxone. This finding supports broad use of the OOKs to assess knowledge gain in opioid education and naloxone distribution trainings for both lay persons such as families, friends, restaurant workers, librarians, and relatives of opioid street drug users as well as the police and emergency medical services professionals. We also identified which items were more difficult for participants and which might require greater focus during OEND trainings.


I hope this article encourages use of the OOKS to evaluate trainings designed to reduce opioid-related fatalities, which continue to take too many lives and which continue in light of ever changing street drug mixtures that now commonly include potent synthetic opioids (fentanyl) and health-damaging adulterants (xylazine, benzodiazepines). Every tool we have to fight this decades-old epidemic is needed, including the ability to tailor trainings after careful evaluation.

James Swartz
University of Illinois at Chicago

Read the Original

This page is a summary of: A measurement invariance analysis of selected Opioid Overdose Knowledge Scale (OOKS) items among bystanders and first responders, PLoS ONE, October 2022, PLOS, DOI: 10.1371/journal.pone.0271418.
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