Perceived availability and carriage of take-home naloxone and factors associated with carriage among people who inject drugs in England, Wales and Northern Ireland

Spring, Christiane; Croxford, Sara; Ward, Zoe; Ayres, Rachel; Lord, Catherine; Desai, Monica; Vickerman, Peter; Artenie, Andreea Adelina

doi:10.1016/j.drugpo.2022.103615

Cited by 2 publications

(1 citation statement)

References 40 publications

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“…In addition, recent injection drug use increased the odds of consistent naloxone carriage. It could be the case that people who inject drugs have greater awareness of their opioid overdose risk, compared to those using other routes of administration, and that they are more likely to receive overdose prevention messaging at SEPs, where naloxone is frequently distributed [ 33 , 34 ]. Notably, harm reduction service delivery was in flux during COVID, especially during the “shutdowns.” At the same time, drug supply was disrupted, and overdoses were on the rise [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Exploration of weekly variation in naloxone possession and carriage among people who use opioids in New York City before, during, and after the COVID-19 pandemic

Roth,

Ward,

Hensel

et al. 2024

PLoS ONE

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Background Naloxone is critical for reversing opioid-related overdoses. However, there is a dearth of research examining how naloxone possession and carriage are impacted by time-varying individual and social determinants, and if this differed during the height of the COVID-related mitigation measures (e.g., shutdowns). Methods We utilized weekly ecological momentary assessments (EMA) to measure factors associated with naloxone possession and carriage among 40 people who use illicit opioids in New York City, for 24 months. Descriptive statistics were used to explore the frequency of weeks with consistent naloxone possession and carriage. Mixed effects binary and multivariable logistic regression was used to test for the impact of time-varying EMA- and baseline-level factors on each outcome. Results Approximately 70% of weekly EMAs were associated with consistent naloxone possession or carriage. In multivariable models, compared to during the height of the COVID-related shutdowns (March 12, 2020-May 19, 2021), the time before was associated with lower odds of consistent possession (Odds Ratio (OR) = 0.05, 95% Confidence Interval (CI) = 0.01–0.15) and consistent carriage (OR = 0.06, CI = 0.01–0.25). Additionally, being female (OR = 11.15, CI = 2.85–43.42), being White versus being Black or Hispanic/Latinx (OR = 8.05, CI = 1.96–33.06), and lifetime overdose (OR = 1.96, CI = 1.16–19.80) were associated with higher odds of consistent possession. Recent opioid injection (OR = 3.66, CI = 1.34–9.94), being female (OR = 7.91, CI = 3.91–8.23), and being White (OR = 5.77, CI = 1.35–24.55) were associated with higher odds of consistent carriage. Not wanting to be perceived as a drug user was reported in nearly one third (29.0%; 190/656) of EMAs where inconsistent possession was reported. Conclusions Our findings paint a relatively positive picture of possession and carriage during COVID-related shutdowns, particularly among white and female participants, and highlight the importance of capturing time-varying factors to understand naloxone-related behavior. To curb growing disparities, outreach to equip Black and Hispanic/Latinx people with naloxone is needed as well as interventions to reduce stigma as a barrier to naloxone engagement.

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Section: Discussionmentioning

confidence: 99%

Exploration of weekly variation in naloxone possession and carriage among people who use opioids in New York City before, during, and after the COVID-19 pandemic

Roth,

Ward,

Hensel

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

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Systematic review and meta-analysis to estimate the burden of non-fatal and fatal overdose among people who inject drugs living in the U.S. and comparator countries: 2010 – 2023

Shealey,

Hall,

Pigott

et al. 2024

Preprint

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BackgroundPeople who inject drugs (PWID) have high risk for overdose, but there are no current estimates of overdose rates in this population. We estimated the rates of non-fatal and fatal overdose among PWID living in the U.S. and comparator countries (Canada, Mexico, United Kingdom, Australia), and ratios of non-fatal to fatal overdose, using literature published 01/01/2010 – 09/29/2023.MethodsPubMed, PsychInfo, Embase, and ProQuest databases were systematically searched to identify publications reporting prevalence or rates of recent (past 12 months) non- fatal and fatal overdose among PWID. Non-fatal and fatal overdose rates were meta-analyzed using random effects models. Risk of bias was assessed using an adapted quality assessment tool, and heterogeneity was explored using sensitivity analyses.ResultsOur review included 143 records, with 58 contributing unique data to the meta- analysis. Non-fatal and fatal overdose rates among PWID in the U.S. were 32.9 per 100 person- years (PY) (95% CI: 26.4 – 40.9; n=28) and 1.7 per 100 PY (95% CI: 0.9 – 3.2; n=4), respectively. Limiting the analysis to data collected after 2016 yielded a non-fatal rate of 41.0 per 100 PY (95% CI: 32.1 – 52.5; n=16) and a fatal rate of 2.5 per 100 PY (95% CI: 1.4 – 4.3; n=2) in the U.S. An estimated 5% of overdoses among PWID in the U.S. result in death. Among the analyzed countries, Australia had the lowest non-fatal and fatal overdose rates and the largest ratio of non-fatal to fatal overdose.ConclusionFindings demonstrate substantial burden of non-fatal and fatal overdose among PWID in the U.S. and comparator countries. Scale-up of interventions that prevent overdose mortality and investments in PWID health research are urgently needed.

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Perceived availability and carriage of take-home naloxone and factors associated with carriage among people who inject drugs in England, Wales and Northern Ireland

Cited by 2 publications

References 40 publications

Exploration of weekly variation in naloxone possession and carriage among people who use opioids in New York City before, during, and after the COVID-19 pandemic

Exploration of weekly variation in naloxone possession and carriage among people who use opioids in New York City before, during, and after the COVID-19 pandemic

Systematic review and meta-analysis to estimate the burden of non-fatal and fatal overdose among people who inject drugs living in the U.S. and comparator countries: 2010 – 2023

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