Naloxone Online Information Exceeds the Recommended Reading Level for Patient Education Materials.

OBJECTIVE: The opioid epidemic claimed 68,630 lives in 2020 in the United States. It reached record levels during the COVID-19 pandemic. Public comprehension of naloxone, the reversal agent for opioid overdoses, is necessary for its broad uptake and the prevention of opioid-related deaths. This study assesses whether online patient education materials for naloxone meet national readability guidelines. It further compares the readability of naloxone materials to that of cardiopulmonary resuscitation (CPR) materials, given that the latter is an established and widespread life-saving procedure. METHOD: We searched Google in March 2022 for three terms: "naloxone," "Narcan," and "CPR." The top 15 websites for each term were retrieved, processed, and inputted into a readability calculator to generate six validated reading scale scores. Statistical analyses were performed to compare the readability of naloxone/Narcan online information against national standards and the readability of CPR online information. RESULTS: The average readability of naloxone/Narcan websites was grade 11.2 ± 2.3, and none of the websites met the recommended sixth-grade reading level for patient education materials. In comparison, the average readability of CPR websites was 7.8 ± 1.5. Of the naloxone/Narcan websites, only 17% (4/24) had a readability at or below the eighth-grade level, the average reading level of US adults. In comparison, 80% (12/15) of the CPR websites had a readability at or below the eighth-grade level. CONCLUSIONS: Naloxone online information exceeds the recommended reading level and that of CPR materials. Online information about naloxone should be simplified to broaden educational access to this life-saving medication.

The Case for Health Reparations.

The disproportionate impact of COVID-19 on racially marginalized communities has again raised the issue of what justice in healthcare looks like. Indeed, it is impossible to analyze the meaning of the word justice in the medical context without first discussing the central role of racism in the American scientific and healthcare systems. In summary, we argue that physicians and scientists were the architects and imagination of the racial taxonomy and oppressive machinations upon which this country was founded. This oppressive racial taxonomy reinforced and outlined the myth of biological superiority, which laid the foundation for the political, economic, and systemic power of Whiteness. Therefore, in order to achieve universal racial justice, the nation must first address science and medicine's historical role in scaffolding the structure of racism we bear witness of today. To achieve this objective, one of the first steps, we believe, is for there to be health reparations. More specifically, health reparations should be a central part of establishing racial justice in the United States and not relegated to a secondary status. While other scholars have focused on ways to alleviate healthcare inequities, few have addressed the need for health reparations and the forms they might take. This piece offers the ethical grounds for health reparations and various justice-focused solutions.

Harm Reduction for Adolescents and Young Adults During the COVID-19 Pandemic: A Case Study of Community Care in Reach.

The coronavirus disease 2019 (COVID-19) pandemic has challenged the ability of harm reduction programs to provide vital services to adolescents, young adults, and people who use drugs, thereby increasing the risk of overdose, infection, withdrawal, and other complications of drug use. To evaluate the effect of the COVID-19 pandemic on harm reduction services for adolescents and young adults in Boston, we conducted a quantitative assessment of the Community Care in Reach (CCIR) youth pilot program to determine gaps in services created by its closure during the peak of the pandemic (March 19-June 21, 2020). We also conducted semistructured interviews with staff members at 6 harm reduction programs in Boston from April 27 through May 4, 2020, to identify gaps in harm reduction services, changes in substance use practices and patterns of engagement with people who use drugs, and how harm reduction programs adapted to pandemic conditions. During the pandemic, harm reduction programs struggled to maintain staffing, supplies, infection control measures, and regular connection with their participants. During the 3-month suspension of CCIR mobile van services, CCIR missed an estimated 363 contacts, 169 units of naloxone distributed, and 402 syringes distributed. Based on our findings, we propose the following recommendations for sustaining harm reduction services during times of crisis: pursuing high-level policy changes to eliminate political barriers to care and fund harm reduction efforts; enabling and empowering harm reduction programs to innovatively and safely distribute vital resources and build community during a crisis; and providing comprehensive support to people to minimize drug-related harms.