Take‐home naloxone to reduce heroin death

Baca, Catherine T.; Grant, Kenneth J.

doi:10.1111/j.1360-0443.2005.01259.x

Cited by 119 publications

(83 citation statements)

References 61 publications

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“…Serious adverse effects of naloxone are rare, and are likely related to the overdose rather than the medication, when administered in either clinical or street settings. [16][17][18][19][20][21][22][23] In March 2010, the Governor of the State of Washington signed overdose intervention legislation that permits the prescription and possession of naloxone, and administration to others suffering from opioid overdoses. 24 This legislation became effective in June 2010 and also includes another relatively uncommon overdose prevention measure in the US-limited immunity from prosecution for drug possession charges for individuals who overdose or seek medical assistance in drug overdoses.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

et al. 2011

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Opioid-involved overdose deaths are on the rise, both nationwide and in the state of Washington. In a survey of 443 participants at syringe exchanges in Seattle, Washington, 16% had overdosed in the last year. Several factors were significantly associated in bivariate analysis: lack of permanent housing; incarceration of five or more days in the past year; gender of sex partners; sharing of syringes and other injection paraphernalia; use of speedballs (cocaine and heroin together), goofballs (methamphetamine and heroin together), buprenorphine; injection use of crack cocaine and sedatives; and use of opioids with sedatives. Adjusting for other variables in multivariate logistic regression analyses, only recent incarceration and sharing of injection materials were still significantly associated with overdose. Correctional facilities, syringe exchange programs, and other agencies serving opioid injectors should include overdose prevention components in release planning and services.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

et al. 2011

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“…13,27,28 Naloxone distribution for administration to IDUs after overdose poses ethical, legal, and practical challenges that have been well documented. 11,27 The main legal issue concerns the provision of a drug for administration to a third party. It is not standard practice for a patient to be prescribed medication to administer to someone else.…”

Section: Discussionmentioning

confidence: 99%

“…1,[5][6][7] Naloxone distribution for peer administration (hereafter referred to as peer naloxone distribution) has been suggested as a strategy to prevent fatal overdose 2,[7][8][9] and has been implemented in countries including Italy, Germany, England, and the United States. 10,11 It has been estimated that the introduction of such programs had saved more than 900 lives by February 2006. 10 While IDU have generally been shown to have positive attitudes toward peer naloxone distribution, 2,6,[12][13][14] concerns have been raised about programs for a variety of reasons including a potential for increased heroin use and the promotion of drug use, 2,6,[15][16][17] questions about the competence of IDU to effectively administer the drug, 9,15 possible adverse reactions, 2,16 and a possible failure to seek subsequent emergency medical support after treatment.…”

Section: Introductionmentioning

confidence: 99%

Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration

et al. 2008

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Naloxone distribution to injecting drug users (IDUs) for peer administration is a suggested strategy to prevent fatal heroin overdose. The aim of this study was to explore attitudes of IDUs to administration of naloxone to others after heroin overdose, and preferences for method of administration. A sample of 99 IDUs (median age 35 years, 72% male) recruited from needle and syringe programs in Melbourne were administered a questionnaire. Data collected included demographics, attitudes to naloxone distribution, and preferences for method of administration. The primary study outcomes were attitudes of IDUs to use of naloxone for peer administration (categorized on a five-point scale ranging from "very good idea" to "very bad idea") and preferred mode of administration (intravenous, intramuscular, and intranasal). The majority of the sample reported positive attitudes toward naloxone distribution (good to very good idea: 89%) and 92% said they were willing to participate in a related training program. Some participants raised concerns about peer administration including the competence of IDUs to administer naloxone in an emergency, victim response on wakening and legal implications. Most (74%) preferred intranasal administration in comparison to other administration methods (21%). There was no association with age, sex, or heroin practice. There appears to be strong support among Australian IDU for naloxone distribution to peers. Intranasal spray is the preferred route of administration.

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“…13 Programs have been implemented in Europe, the US and Australia since the mid-1990s. 9,14,15 The first Canadian THN community program was initiated in 2005 by Streetworks in Edmonton, Alberta 16 and there are now programs in the majority of Canada's provinces and territories. 17 The implementation of such programs reduces mortality from opioid poisonings.…”

mentioning

confidence: 99%

“…17 The implementation of such programs reduces mortality from opioid poisonings. 15,18 A province-wide THN program is a key aspect of Alberta's response to the opioid crisis. Other aspects include surveillance of emerging substances (including for illicit drugs), drug use prevention and education programs, Indigenous-focused and rural opioid dependence treatment, enhanced access to opioid replacement therapies, and strengthened harm reduction policy.…”

mentioning

confidence: 99%

Alberta’s provincial take-home naloxone program: A multi-sectoral and multi-jurisdictional response to overdose

Freeman

Bourque²,

Etches

et al. 2017

Can J Public Health

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SETTING: Alberta is a prairie province located in western Canada, with a population of approximately 4.3 million. In 2016, 363 Albertans died from apparent drug overdoses related to fentanyl, an opioid 50-100 times more toxic than morphine. This surpassed the number of deaths from motor vehicle collisions and homicides combined.INTERVENTION: Naloxone is a safe, effective, opioid antagonist that may quickly reverse an opioid overdose. In July 2015, a committee of communitybased harm reduction programs in Alberta implemented a geographically restricted take-home naloxone (THN) program. The successes and limitations of this program demonstrated the need for an expanded, multi-sectoral, multi-jurisdictional response. The provincial health authority, Alberta Health Services (AHS), used previously established incident command system processes to coordinate implementation of a provincial THN program.OUTCOMES: Alberta's provincial THN program was implemented on December 23, 2015. This collaborative program resulted in a coordinated response across jurisdictional levels with wide geographical reach. Between December 2015 and December 2016, 953 locations, including many community pharmacies, registered to dispense THN kits, 9572 kits were distributed, and 472 reversals were reported. The provincial supply of THN kits more than tripled from 3000 to 10 000. IMPLICATIONS:Alberta was uniquely poised to deliver a large, province-wide, multi-sectoral and multi-jurisdictional THN program as part of a comprehensive response to increasing opioid-related morbidity and mortality. The speed at which AHS was able to roll out the program was made possible by work done previously and the willingness of multiple jurisdictions to work together to build on and expand the program.KEY WORDS: Fentanyl; take-home naloxone; harm reduction; opioid overdose La traduction du résumé se trouve à la fin de l'article.

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Take‐home naloxone to reduce heroin death

Cited by 119 publications

References 61 publications

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration

Alberta’s provincial take-home naloxone program: A multi-sectoral and multi-jurisdictional response to overdose

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