Substance Use and Overdose in Pennsylvania Libraries, 2019

This study examines the implementation of naloxone distribution initiatives in Pennsylvania public libraries following a nationwide program offering free Narcan. We conducted a cross-sectional telephone survey with a random sample of Pennsylvania public libraries (n=352). Overall, nearly one-quarter of respondents reported stocking naloxone (23.9%), and over one in ten libraries reported a previous on-site overdose (11.9%). Nearly 30% of respondents had received naloxone training. Significant predictors of on-site overdoses included the library’s county urbanization status and higher county-level overdose mortality rates. Among libraries that stocked naloxone, 73% obtained the medication from local health departments or community-based organizations. This study underscores the role of public libraries in opioid overdose crisis response and the need for tailored strategies to enhance naloxone accessibility, especially in high-risk urban areas. Collaboration between libraries, public health entities, and pharmaceutical companies is crucial to amplify naloxone distribution efforts and address the escalating opioid overdose crisis. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Institutional Review Board University of Pennsylvania I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes A limited dataset produced in the present study is available upon reasonable request to the authors