ABSTRACT
The initial reconnaissance of the heliosphere and very local interstellar medium (VLISM) is complete with in situ measurements, observations of energetic neutral atoms (ENAs), neutral VLISM H and He, UV emissions, and interstellar dust. After many COVID related delays, the workshop "The heliosphere in the local interstellar medium" took place at ISSI from 8-12 November 2021. Edited by John D. Richardson, Andrei Bykov, Frederic Effenberger, Klaus Scherer, Veerle Sterken, Rudolf von Steiger and Gary P. Zank The first International Space Science Institute (ISSI) book in the I Space Sciences Series of ISSI i was "The Heliosphere in the Local Interstellar Medium: Proceedings of the First ISSI Workshop 6-10 November 1995, Bern, Switzerland" edited by R. von Steiger, R. Lallement, and M.A. Lee and published in 1996. [Extracted from the article] Copyright of Space Science Reviews is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
ABSTRACT
BACKGROUND: The United States is in the midst of an opioid epidemic within the COVID-19 pandemic, and veterans are twice as likely to die from accidental overdose compared to non-veterans. This article describes the Veterans Health Administration (VHA) Rapid Naloxone Initiative, which aims to prevent opioid overdose deaths among veterans through (1) opioid overdose education and naloxone distribution (OEND) to VHA patients at risk for opioid overdose, (2) VA Police naloxone, and (3) select automated external defibrillator (AED) cabinet naloxone. METHODS: VHA has taken a multifaceted, theory-based approach to ensuring the rapid availability of naloxone to prevent opioid overdose deaths. Strategies targeted at multiple levels (for example, patient, provider, health care system) have enabled synergies to speed diffusion of this lifesaving practice. RESULTS: As of April 2021, 285,279 VHA patients had received naloxone from 31,730 unique prescribers, with 1,880 reported opioid overdose reversals with naloxone; 129 VHA facilities had equipped 3,552 VA Police officers with naloxone, with 136 reported opioid overdose reversals with VA Police naloxone; and 77 VHA facilities had equipped 1,095 AED cabinets with naloxone, with 10 reported opioid overdose reversals with AED cabinet naloxone. Remarkably, the COVID-19 pandemic had minimal impact on naloxone dispensing to VHA patients. CONCLUSION: The VHA Rapid Naloxone Initiative saves lives. VHA is sharing many of the tools and resources it has developed to support uptake across other health care systems. Health care systems need to work together to combat this horrific epidemic within a pandemic and prevent a leading cause of accidental death (opioid overdose).