Factors associated with take-home naloxone kit usage in British Columbia: an analysis of administrative data

Abstract

Background The British Columbia (BC) Take-Home Naloxone (THN) program provides naloxone to people at risk of experiencing or witnessing an opioid overdose for use in reversing suspected overdose events. This study seeks to examine trends and correlates of individuals obtaining a THN kit in BC between 2017 and 2020. Methods Records of THN kits distributed between 2017 and 2020 were the primary source of data for this analysis. Frequency tables were used to describe characteristics of people obtaining kits from THN sites. Correlates of individuals obtaining a THN kit to replace a previous kit reported as used to reverse an overdose were assessed with multivariate logistic regression. Results Between January 1, 2017, and December 31, 2020, 240,606 THN kits were reported distributed by registered sites to members of the public, with 90,011 records indicating that a kit was obtained to replace a previous kit that had been used to reverse an overdose. There was a significant trend in increasing kits reported used by year (p < 0.01). The kit recipient’s risk of overdose was a significant predictor of having reported using a THN kit, and the strength of the association was dependent on gender (Male: Adjusted odds ratio (AOR) 5.37 [95% confidence interval (CI) 5.08 – 5.67]; Female: AOR 8.35 [95% CI 7.90 – 8.82]; Trans and gender expansive: AOR 3.68 [95% CI 2.82 – 4.79]). Conclusions Between 2017 and 2020, THN kits were used to reverse tens of thousands of overdose events in BC, with people at risk of overdose (i.e. people who use drugs [PWUD]) having greater odds of using a kit to reverse an overdose than those not at risk. Thus, PWUD are responsible for reversing the vast majority of overdoses. THN kits are being distributed to the people who use them most. However, additional strategies in conjunction with community-based naloxone distribution programs are needed to address the rising number of illicit drug toxicity deaths.

Feasibility and acceptability of inserts promoting virtual overdose monitoring services (VOMS) in naloxone kits: a qualitative study

“…While VOMS aim to provide options to those who do not have access to current harm reduction services, naloxone programs may not adequately reach communities of vulnerable rural users. Though traditionally distributed by pharmacies, harm reduction agencies and hospitals in Canada [ 23 ], other programs like Philadelphia's Mail order naloxone program may act to spread awareness of VOMS, the harms of using alone and access to naloxone kits for those most in need [ 26 ]. Respondents in the study highlighted how it was equally crucial for distributors of naloxone kits to discuss VOMS’ and indicate to individuals that they could find more information on these services inside (or outside) the kits themselves.…”

Associations with experience of non-fatal opioid overdose in British Columbia, Canada: a repeated cross sectional survey study

“…People with lived and living experience of substance use are the forefront of the unregulated drug poisoning emergency [ 30 , 31 ], and carry the burden of saving lives of friends, family, and other community members [ 32 ]. Responders often experience overwhelming loss, burnout, and frustration, and severe grief and loss responses are associated with experiencing or witnessing an overdose [ 32 , 33 ].…”

Priority setting for Canadian Take-Home Naloxone best practice guideline development: an adapted online Delphi method

“…PWLLE who provide harm reduction services including overdose response are uniquely knowledgeable about harm reduction practices and services, engaging communities of people who use drugs (PWUD), and creating comfortable and safe service environments [ 29 , 30 ]. As we have seen in a recent analysis of BC Take-Home Naloxone kit distribution data, PWUD are the group most likely to receive a kit because their previous kit was used to reverse an overdose; thus PWUD are key stakeholders, both as the people who will benefit from THN programs and policies and who save lives using THN [ 31 , 32 ]. Other committee members offered valuable insights from clinical (with representation from harm reduction, nursing, pharmacy, and medicine), public health, and academic perspectives from different provinces and territories within Canada.…”