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Naloxone distribution and possession following a large‐scale naloxone programme
Author(s) -
MadahAmiri Desiree,
Gjersing Linn,
Clausen Thomas
Publication year - 2019
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.14425
Subject(s) - (+) naloxone , medicine , possession (linguistics) , confidence interval , demography , odds , odds ratio , logistic regression , population , opioid , environmental health , sociology , linguistics , philosophy , receptor
Aims To examine uptake following a large‐scale naloxone programme by estimating distribution rates since programme initiation and the proportion among a sample of high‐risk individuals who had attended naloxone training, currently possessed or had used naloxone. We also estimated the likelihood of naloxone possession and use as a function of programme duration, individual descriptive and substance use indicators. Design (1) Distribution data (June 2014–August 2017) and date of implementation for each city and (2) a cross‐sectional study among a sample of illicit substance users interviewed September 2017. Setting Seven Norwegian cities. Participants A total of 497 recruited users of illegal opioids and/or central stimulants. Measurements Primary outcomes: naloxone possession and use. Random‐intercepts logistic regression models (covariates: male, age, homelessness/shelter use, overdose, incarceration, opioid maintenance treatment, income sources, substance use indicators, programme duration). Findings Overall, 4631 naloxone nasal sprays were distributed in the two pilot cities, with a cumulative rate of 495 per 100 000 population. In the same two cities, among high‐risk individuals, 44% and 62% reported current naloxone possession. The possession rates of naloxone corresponded well to the duration of each participating city's distribution programme. Overall, in the six distributing cities, 58% reported naloxone training, 43% current possession and 15% naloxone use. The significant indicators for possession were programme duration [adjusted odds ratios (aOR) = 1.44, 95% confidence interval (CI = 0.82–2.37], female gender (aOR = 1.97, 95% CI = 1.20–3.24) and drug‐dealing (aOR = 2.36, 95% CI = 1.42–3.93). The significant indicators for naloxone use were programme duration (aOR = 1.49 95%, CI = 1.15–1.92), homelessness/shelter use (aOR = 2.06, 95% CI = 1.02–4.17), opioid maintenance treatment (OMT) (aOR = 2.07, 95% CI = 1.13–3.78), drug‐dealing (aOR = 2.40, 95% CI = 1.27–4.54) and heroin injecting (aOR = 2.13, 95% CI = 1.04–4.38). Conclusions A large‐scale naloxone programme in seven Norwegian cities with a cumulative distribution rate of 495 per 100 000 population indicated good saturation in a sample of high‐risk individuals, with programme duration in each city as an important indicator for naloxone possession and use.