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Universal Precautions for North Americans at Risk of Opioid Overdose

Four proven clinical interventions “should constitute a set of ‘universal precautions’ that clinicians and health systems could implement to reduce opioid overdose deaths among at-risk patients, including all patients who use opioids or who may be inadvertently exposed to fentanyl,” write authors of a Viewpoint article. “Given the remarkable ongoing discordance between overdose-prevention interventions and service delivery, the definition of a suite of evidence-based interventions and education in support of clinical culture change are long overdue and should be prioritized so that health systems may apply these universal precautions to close the implementation gap for overdose prevention,” the authors conclude.

The universal precautions are as follows:

  • Offer medications to individuals with opioid use disorder interested in reducing their use or managing overdose risk
  • Provide naloxone to people who use drugs, and ensure training in its proper use
  • Offer take-home fentanyl test strips to people who use opioids or other drugs that may be fentanyl contaminated (e.g., cocaine, methamphetamine, or pills purchased in the illicit market)
  • Counsel people who use drugs on how to reduce their risk of fatal overdose:
    • Never use when the individual is alone
    • Start with only a small amount of a drug to assess its potency
    • Try to avoid mixing opioids and other sedatives (e.g., benzodiazepines or alcohol)
Source: JAMA Internal Medicine