Teaching Adults to Recognize and Respond to Suspected Opioid Overdose: A Proof‐of‐Concept Evaluation

ABSTRACT The opioid crisis remains a major public health emergency in the United States, with over 100,000 drug overdose deaths reported in 2023, nearly 80,000 involving opioids. Naloxone is available over the counter and can reverse the effects of opioid overdose, but responding effectively requires more than operating the device. Bystanders must discriminate suspected overdose from other presentations, administer naloxone, contact emergency services, monitor the person, and decide whether to repeat dosing. Overdose education and naloxone distribution programs typically evaluate outcomes with knowledge tests and self‐report, whereas direct measures of this response chain are rare. In this proof‐of‐concept evaluation, we developed task analyses and a contingency‐based simulation to directly measure the response of three adults, and we evaluated behavioral skills training (BST) in a nonconcurrent multiple baseline across participants design. During baseline, the naloxone trainer and the manufacturer's written directions were available. No participant met the mastery criterion and steps included in the directions were rarely performed. Following BST, all participants demonstrated mastery‐level responding across the three training scenarios, correct responding during context‐generalization probes, and returned high social validity ratings. We discuss what the current evaluation can and cannot conclude about training and the research that should follow on this socially important target response.