Overdose training and take‐home naloxone for opiate users: prospective cohort study of impact on knowledge and attitudes and subsequent management of overdoses

Strang, John; Manning, Victoria; Mayet, Soraya; Best, David; Titherington, Emily; Costa, Laura Emmanuela Lima; Offor, Elizabeth; Semmler, Claudia

doi:10.1111/j.1360-0443.2008.02314.x

Cited by 154 publications

(153 citation statements)

References 46 publications

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“…Since the 1980s, naloxone has been available as an over-the-counter medication in Italy and distributed through lowthreshold services in Berlin, Germany; Jersey, UK; and San Francisco, USA (Dettmer et al, 2001). Preliminary results indicate lifesaving events through peer administration of naloxone (Strang et al, 2008;Seal et al, 2005).…”

Section: Discussionmentioning

confidence: 89%

“…First, it is important to ensure that clients in MFIT/TCs take part as early as in overdose prevention awareness programmes with particular emphasis on the nature of overdose risk in the event of leaving treatment prematurely. Studies show that drug users are an overlooked potential workforce, interested in and willing to attend preventive training courses and to apply such knowledge when necessary (Strang et al, 2008;Baca and Grant, 2007;Lagu et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…Second, programmes to prevent fatal overdoses may be established and evaluated in the community, using resuscitation techniques as well as opioid antagonist medication such as naloxone (Strang et al, 2008;Piper et al, 2007;Galea et al, 2006). Since the 1980s, naloxone has been available as an over-the-counter medication in Italy and distributed through lowthreshold services in Berlin, Germany; Jersey, UK; and San Francisco, USA (Dettmer et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…Actually, deaths from opiate overdose comprise the vast majority of all drugrelated deaths (Strang et al, 2008;Darke and Zador, 1996). One situation of the utmost importance in relation to overdose deaths, and where the prevalence of overdoses seems to be especially high, is in the period of time immediately after release from prison.…”

Section: Introductionmentioning

confidence: 99%

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Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Ravndal

Amundsen²

2010

Drug and Alcohol Dependence

105

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Background:Drug users who are leaving/completing inpatient medication-free treatment may, like drug users released from prison, have an elevated risk of dying from fatal overdoses. This is mainly explained by their low drug tolerance. Methods:Two hundred and seventy-six drug users who had been admitted to eleven inpatient facilities in Norway, were followed prospectively after discharge from treatment during an eight year period (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). The following instruments were used: EuropASI, SCL-25 and MCMI-II.Information on deaths and causes of death were obtained from the National Death Register. Results:A total of 36 deaths were registered after discharge from treatment during the observation period, of which 24 were classified as overdose deaths. During the first 4 weeks after discharge six persons died, yielding an unadjusted excess mortality of 15.7 (rate ratio) in this period (CI 5.3-38.3). All were dropouts and all deaths were classified as opiate overdoses.There was no significant association between time in index treatment and mortality after discharge, nor did any background characteristics correlate significantly with elevated mortality shortly after discharge. Conclusions:The elevated risk of dying from overdose within the first four weeks of leaving medicationfree inpatient treatment is so dramatic that preventive measures should be taken. More studies from similar inpatient programmes are needed in order to obtain systematic knowledge about determinants of overdose deaths shortly after leaving treatment, and possible preventive measures..

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Ravndal

Amundsen²

2010

Drug and Alcohol Dependence

105

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“…By the 2010s intervention studies typically reported the number of overdoses reversed with naloxone as a central outcome; high naloxone usage rates confirmed the 'trainability' of heroin users to adequately respond to overdose (Green et al, 2008;Lopez-Gaston et al, 2009;Markham-Piper et al, 2008;McAuley et al, 2010;Strang et al, 2008a;Tobin et al, 2009;Wagner et al, 2010). A systematic review of naloxone usage rates found that, for every 100 opioid users trained and supplied with THN, 9% of THN kits are likely used for overdose reversal within the first three months post-training (McAuley et al, 2015).…”

Section: -2016 Circa: Emergence Of Stronger Data Alternative Impmentioning

confidence: 99%

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

McDonald

Campbell

Strang

2017

Drug and Alcohol Dependence

Self Cite

110

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Highlights Deaths from opioid overdose can be prevented by prompt administration of naloxone  It has been 20 years since take-home naloxone provision was first proposed  Take-home naloxone programs have recently overcome legal barriers in many countries  Take-home naloxone provision remains low compared to evident growing clinical need  The 'opt-out' model of required pre-provision may achieve wider naloxone coverage Abstract Background: Opioid overdose is a major cause of mortality, but injury and fatal outcomes can be prevented by timely administration of the opioid antagonist naloxone. Pre-provision of naloxone to opioid users and family members (take-home naloxone, THN) was first proposed in 1996, and WHO Guidelines were issued in 2014. While widespread in some countries, THN is minimally available or absent elsewhere. This review traces the development of THN over twenty years, from speculative harm reduction proposal to public health strategy.Method: Medline and PsycINFO were searched for peer-reviewed literature using Boolean queries: 1) "naloxone OR Narcan"; 2) "(opioid OR opiate) AND overdose AND prevention". Grey literature and specialist websites were also searched. Data were extracted and synthesized as narrative review, with key events presented as chronological timeline. Results Conclusions:Framed as a public health tool for harm reduction, THN has overcome social, clinical, and legal barriers in many jurisdictions. Nonetheless, the rising death toll of opioid overdose illustrates that current THN coverage is insufficient, and greater public investment in overdose prevention will be required if THN is to achieve its full potential impact.

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Opioid Overdose Fatality Prevention

Leece¹,

Orkin²

2013

JAMA

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Overdose training and take‐home naloxone for opiate users: prospective cohort study of impact on knowledge and attitudes and subsequent management of overdoses

Cited by 154 publications

References 46 publications

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Mortality among drug users after discharge from inpatient treatment: An 8-year prospective study

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

Opioid Overdose Fatality Prevention

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