Process evaluation of the Prevent Overdose in Toronto (POINT) program

SETTING: A harm reduction program at a public health unit in Toronto, Ontario, between August 31, 2011 and August 31, 2013. INTERVENTION: We conducted a process evaluation of the first two years of an opioid overdose prevention and response program, Prevent Overdose in Toronto (POINT), including analysis of data from program documentation forms, as well as qualitative interviews with program staff, representatives from partner agencies, and program clients. OUTCOMES: In the first two years of the program, 662 individuals (52.4% male; mean age 38.3 years) were trained in opioid overdose prevention and given a naloxone kit. Among clients currently using opioids, the most frequently reported opioids were oxycodone (40.4%) and heroin (34.4%). Clients reported 98 administrations of naloxone, primarily to friends and acquaintances. Nearly all naloxone recipients reportedly survived; one did not survive, and one had an unknown outcome. Staff and partner agencies feel the program reaches the target population and that POINT training meets clients’ needs. Clients would like to see the training offered more widely. Overall, staff, partner agencies and clients were pleased with the POINT program, and they offered suggestions on program recruitment and delivery. IMPLICATIONS: Individuals at risk of opioid overdose have participated in overdose prevention and response training, and reported using naloxone in overdose events. Results of this initial program evaluation are being used to improve the delivery of the POINT program and can inform broader public health practice in opioid overdose prevention.