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Predictors of participant engagement and naloxone utilization in a community‐based naloxone distribution program
Author(s) -
Rowe Christopher,
Santos GlennMilo,
Vittinghoff Eric,
Wheeler Eliza,
Davidson Peter,
Coffin Philip O.
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12961
Subject(s) - (+) naloxone , psychology , opioid overdose , distribution (mathematics) , medicine , clinical psychology , medical emergency , opioid , mathematics , receptor , mathematical analysis
Abstract Aims To describe characteristics of participants and overdose reversals associated with a community‐based naloxone distribution program and identify predictors of obtaining naloxone refills and using naloxone for overdose reversal. Design Bivariate statistical tests were used to compare characteristics of participants who obtained refills and reported overdose reversals versus those who did not. We fitted multiple logistic regression models to identify predictors of refills and reversals; zero‐inflated multiple Poisson regression models were used to identify predictors of number of refills and reversals. Setting San Francisco, California, USA. Participants Naloxone program participants registered and reversals reported from 2010 to 2013. Measurements Baseline characteristics of participants and reported characteristics of reversals. Findings A total of 2500 participants were registered and 702 reversals were reported from 2010 to 2013. Participants who had witnessed an overdose [adjusted odds ratio (AOR) = 2.02, 95% confidence interval (CI) = 1.53–2.66; AOR = 2.73, 95% CI = 1.73–4.30] or used heroin (AOR = 1.85, 95% CI = 1.44–2.37; AOR = 2.19, 95% CI = 1.54–3.13) or methamphetamine (AOR = 1.71, 95% CI = 1.37–2.15; AOR = 1.61, 95% CI = 1.18–2.19) had higher odds of obtaining a refill and reporting a reversal, respectively. African American (AOR = 0.63, 95% CI = 0.45–0.88) and Latino (AOR = 0.65, 95% CI = 0.43–1.00) participants had lower odds of obtaining a naloxone refill, whereas Latino participants who obtained at least one refill reported a higher number of refills [incidence rate ratio (IRR) = 1.33 (1.05–1.69)]. Conclusions Community naloxone distribution programs are capable of reaching sizeable populations of high‐risk individuals and facilitating large numbers of overdose reversals. Community members most likely to engage with a naloxone program and use naloxone to reverse an overdose are active drug users.