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{
    "pk": 11455,
    "title": "Geospatial Clustering of Opioid-Related Emergency Medical Services Runs for Public Deployment of Naloxone",
    "subtitle": null,
    "abstract": "Introduction:\n The epidemic of opioid use disorder and opioid overdose carries extensive morbidity and mortality and necessitates a multi-pronged, community-level response. Bystander administration of the opioid overdose antidote naloxone is effective, but it is not universally available and requires consistent effort on the part of citizens to proactively carry naloxone. An alternate approach would be to position naloxone kits where they are most needed in a community, in a manner analogous to automated external defibrillators. We hypothesized that opioid overdoses would show geospatial clustering within a community, leading to potential target sites for such publicly deployed naloxone (PDN).\nMethods:\n We performed a retrospective chart review of 700 emergency medical service (EMS) runs that involved opioid overdose or naloxone administration in Cambridge, Massachusetts, between 10/16/2016 and 05/10/2017. We used geospatial analysis to examine for clustering in general, and to identify specific clusters amenable to PDN sites.\nResults:\n Opioid-related EMS runs in Cambridge, MA, exhibit significant geospatial clustering, and we identified three clusters of opioid-related EMS runs in Cambridge with distinct characteristics. Models of PDN sites at these clusters show that approximately 40% of all opioid-related EMS runs in Cambridge, MA, would be accessible within 200 meters of PDN sites placed at cluster centroids.\nConclusion:\n Identifying clusters of opioid-related EMS runs within a community may help to improve community coverage of naloxone, and strongly suggests that PDN could be a useful adjunct to bystander-administered naloxone in stemming the tide of opioid-related death.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Geospatial Analysis"
        },
        {
            "word": "Opioid"
        },
        {
            "word": "emergency medical services"
        }
    ],
    "section": "Public Health",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/86s056g0",
    "frozenauthors": [
        {
            "first_name": "Daniel",
            "middle_name": "A.",
            "last_name": "Dworkis",
            "name_suffix": "",
            "institution": "Keck School of Medicine of University of Southern California, Department of Emergency Medicine, Los Angeles, California \nThe Lever Institute, Los Angeles, California",
            "department": "None"
        },
        {
            "first_name": "Scott",
            "middle_name": "G.",
            "last_name": "Weiner",
            "name_suffix": "",
            "institution": "Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \nHarvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Vincent",
            "middle_name": "T.",
            "last_name": "Liao",
            "name_suffix": "",
            "institution": "Harvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Danielle",
            "middle_name": "",
            "last_name": "Rabickow",
            "name_suffix": "",
            "institution": "Professional Ambulance, Cambridge, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Scott",
            "middle_name": "A.",
            "last_name": "Goldberg",
            "name_suffix": "",
            "institution": "Brigham and Women’s Hospital, Department of Emergency Medicine, Boston, Massachusetts \nHarvard Medical School, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2017-11-15T18:45:53Z",
    "date_accepted": "2017-11-15T18:45:53Z",
    "date_published": "2018-05-15T17:38:10Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/11455/galley/6195/download/"
        }
    ]
}