All ETDs from UAB

Advisory Committee Chair

Karen Cropsey

Advisory Committee Members

Andres Azuero

Burel Goodin

Richard Shelton

Jarred Younger

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


Drug overdose is the primary cause of accidental death in the United States, with a majority of those fatalities involving opioids. Annual rates of fatal opioid overdoses have exponentially increased over the past two decades, leading to the declaration of the current opioid epidemic. The severity of the epidemic has increased due to an upsurge in the use of heroin, synthetic opioids (e.g., fentanyl), and the lacing of other substances with synthetic opioids. As such, federal agencies have made recommendations aimed at combating fatal opioid overdose including the enhancement of naloxone distribution. Administration of naloxone has been expanded from emergency department settings to non-medical first responders and laypersons, allowing for administration of naloxone while waiting for emergency medical services. Opioid Overdose Education and Naloxone Distribution (OEND) programs train laypersons to recognize and respond to opioid overdose and equip them with naloxone. These programs have been shown to effectively reduce overdose mortality. However, implementation has been substandard, and accessibility is limited due to programs typically being located in urban areas at research institutions or drug treatment centers. Individuals who have not presented to treatment or who live in areas without these programs or services lack access to life-saving OEND. Thus, this project aimed to provide preliminary information to ultimately enhance OEND practices by 1) evaluating the feasibility of applying remote methodologies to the OEND iv model; 2) identifying characteristics of individuals most interested in receiving OEND; and 3) examining continued criticisms of naloxone possession. Overall, feasibility and acceptability of online opioid overdose and naloxone administration training and postal distribution of naloxone was supported. Differences were identified between individuals who elected to participate in training and those who declined, potentially indicating that OEND programs could benefit from tailoring information and highlighting training benefits for those most likely to decline. Similar to previous research, naloxone possession in this sample did not appear to negatively impact opioid use or interest in treatment, further suggesting that residual unfounded criticisms should not inhibit naloxone distribution. Overall, implementation of remote OEND methodology could greatly expand access to this life-saving intervention and reduce the severity of the opioid epidemic.



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