Opioid overdose prevention with intranasal naloxone among people who take methadone

Walley, Alexander Y.; Doe-Simkins, Maya; Quinn, Emily; Pierce, Courtney E.; Xuan, Ziming; Ozonoff, Al

doi:10.1016/j.jsat.2012.07.004

Cited by 94 publications

(80 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since the early 2000s, nasal naloxone has been used off-label by ambulance personnel (Barton et al, 2005(Barton et al, , 2002Belz et al, 2006;Kelly et al, 2005;Kerr et al, 2009;Merlin et al, 2010;Robertson et al, 2009;Weber et al, 2012) and in the emergency department (Sabzghabaee et al, 2014). More recently, improvised nasal kits (consisting of a prefilled naloxone syringe and an atomizer which fits onto the syringe to generate a nasal spray) have been provided to opioid users, peers, and families in take-home naloxone trials (Doe-Simkins et al, 2009;Dwyer et al, 2015;Walley et al, 2013aWalley et al, , 2013b, and succesful overdose reversals using improvised nasal kits have also been reported for police first responders (Rando et al, 2015). However, the only published pharmacokinetics study in humans found intranasal naloxone (2mg/5ml) had a relative bioavailability of only 4% (Dowling et al, 2008).…”

Section: Sublingualmentioning

confidence: 99%

Naloxone without the needle − systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal

Strang

McDonald

Alqurshi

et al. 2016

Drug and Alcohol Dependence

View full text Add to dashboard Cite

. (2016). Naloxone without the needle systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal. Drug and Alcohol Dependence. DOI: 10.1016DOI: 10. /j.drugalcdep.2016 Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. After 40 years of injection-based naloxone treatment, non-injectable routes are finally being developed. Nasal naloxone has recently been approved and will soon be fieldtested, buccal naloxone holds promise, and it is unclear what sublingual naloxone will contribute. Development and approval of reliable non-injectable formulations will facilitate wider naloxone provision across the community internationally.

show abstract

Section: Sublingualmentioning

confidence: 99%

Naloxone without the needle − systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal

Strang

McDonald

Alqurshi

et al. 2016

Drug and Alcohol Dependence

View full text Add to dashboard Cite

show abstract

“…The evolving practice is to treat opioid overdose prehospital by prescribing naloxone, the opioid antidote, to an individual or family with one or more residents at risk of opioid overdose [Goodman and Gilman, 2001;Doe-Simkins et al 2009;Wheeler et al 2012;Sporer and Kral, 2007;Walley et al 2013aWalley et al , 2013b. Naloxone is a competitive antagonist to opioids in the central nervous system and has been approved as a prescription medication in the US since 1971.…”

Section: Introductionmentioning

confidence: 99%

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access

Wermeling

2015

Therapeutic Advances in Drug Safety

132

101

View full text Add to dashboard Cite

Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/ emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid overdose and prevention of opioid-induced mortality.

show abstract

“…Further, we found that staff, local agencies and clients viewed the program positively. The POINT program enrollment was higher than in many other programs reported in the literature, 10 but less than in the programs in British Columbia, 7 Massachusetts, 15,20 Chicago, 21 and San Francisco, 22 although the population base served by these programs varies. The demographics and drug use pattern among POINT clients were comparable to those in other programs.…”

Section: Prevent Overdose In Toronto -Evaluationmentioning

confidence: 74%

Process evaluation of the Prevent Overdose in Toronto (POINT) program

Leece

Gassanov

Hopkins

et al. 2016

Can J Public Health

View full text Add to dashboard Cite

SETTING: A harm reduction program at a public health unit in Toronto, Ontario, between August 31, 2011 and August 31, 2013. INTERVENTION:We conducted a process evaluation of the first two years of an opioid overdose prevention and response program, Prevent Overdose in Toronto (POINT), including analysis of data from program documentation forms, as well as qualitative interviews with program staff, representatives from partner agencies, and program clients. OUTCOMES:In the first two years of the program, 662 individuals (52.4% male; mean age 38.3 years) were trained in opioid overdose prevention and given a naloxone kit. Among clients currently using opioids, the most frequently reported opioids were oxycodone (40.4%) and heroin (34.4%). Clients reported 98 administrations of naloxone, primarily to friends and acquaintances. Nearly all naloxone recipients reportedly survived; one did not survive, and one had an unknown outcome.Staff and partner agencies feel the program reaches the target population and that POINT training meets clients' needs. Clients would like to see the training offered more widely. Overall, staff, partner agencies and clients were pleased with the POINT program, and they offered suggestions on program recruitment and delivery.IMPLICATIONS: Individuals at risk of opioid overdose have participated in overdose prevention and response training, and reported using naloxone in overdose events. Results of this initial program evaluation are being used to improve the delivery of the POINT program and can inform broader public health practice in opioid overdose prevention.KEY WORDS: Drug overdose; naloxone; program evaluation La traduction du résumé se trouve à la fin de l'article.

show abstract

Opioid overdose prevention with intranasal naloxone among people who take methadone

Cited by 94 publications

References 42 publications

Naloxone without the needle − systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal

Naloxone without the needle − systematic review of candidate routes for non-injectable naloxone for opioid overdose reversal

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access

Process evaluation of the Prevent Overdose in Toronto (POINT) program

Contact Info

Product

Resources

About