Background: Take home naloxone programs have been successful internationally in training bystanders to reverse an opioid overdose with naloxone, an opioid antagonist. A multi-site naloxone distribution program began in Norway in 2014 as part of a national overdose prevention strategy. The aim of this study was to a) describe the program, and b) present findings from the government-supported intervention.
Methods: From July 2014 to December 2015, staff from multiple low-threshold facilities trained clients on how to use intranasal naloxone. Distribution occurred without an individual prescription or physician present. Questionnaires from initial and refill trainings were obtained, and distribution rates were monitored.
Results: There were 2056 naloxone sprays distributed from one of the 20 participating facilities, with 277 reports of successful reversals. Participants exhibited known risks for overdosing, with injecting (p=0.02, OR=2.4, 95% CI=1.14, 5.00) and concomitant benzodiazepine use (p=0.01, OR=2.6, 95% CI=1.31, 5.23) being significant predictors for having had high rates of previous overdoses. Suggested target coverage for large-scale programs was met, with an annual naloxone distribution rate of 144 per 100,000 population, as well as 12 times the cities mean annual number of opioid-related deaths.
Conclusion: A government-supported multisite naloxone initiative appears to achieve rapid, high volume distribution of naloxone to an at-risk population.
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http://dx.doi.org/10.1016/j.drugalcdep.2016.12.013 | DOI Listing |
Introduction: Mu-opioid receptors (MORs) are G-coupled protein receptors with a high affinity for both endogenous and exogenous opioids. MORs are widely expressed in the central nervous system (CNS), peripheral organs, and the immune system. They mediate pain and reward and have been implicated in the pathophysiology of opioid, cocaine, and other substance use disorders.
View Article and Find Full Text PDFPrehosp Emerg Care
January 2025
Department of Emergency Medicine, MetroHealth Medical Center, Cleveland, OH.
Objectives: Opioid-associated fatal and non-fatal overdose rates continue to rise. Prehospital overdose education and naloxone distribution (OEND) programs are attractive harm-reduction strategies, as patients who are not transported by EMS after receiving naloxone have limited access to other interventions. This narrative summary describes our experiences with prehospital implementation of evidence-based OEND practices across Ohio as part of the HEALing Communities Study (HCS).
View Article and Find Full Text PDFJ Opioid Manag
January 2025
Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill; South East Area Health Education Center, College of Nursing, University of North Carolina Wilmington, Wilmington, North Carolina. ORCID: https://orcid.org/0000-0002-7507-0631.
With the Food and Drug Administration's approval of the first over-the-counter naloxone nasal spray in 2023, it was expected that access to naloxone nasal spray would increase and that its cost would be reduced. However, the writers of this commentary found varying insurance coverage of naloxone during purchase attempts at local pharmacies. Failure to cover naloxone can reduce access and increase risk of overdose death.
View Article and Find Full Text PDFPublic Health Rep
January 2025
Department of Social Work, School of Social Sciences and Education, California State University, Bakersfield, Bakersfield, CA, USA.
To reduce opioid-related morbidity and mortality, local coalitions on substance use prevention in Kern County, California, have sought to increase equitable engagement and reengagement with harm reduction supplies, including naloxone. Through a community-academic partnership and funding from the local managed health care plan in Kern County, we ordered, stocked, and monitored a temperature-controlled outdoor harm reduction vending machine (HRVM) in Bakersfield, California. We outlined the necessary steps for successful procurement and implementation of community-based HRVMs.
View Article and Find Full Text PDFJ Subst Use Addict Treat
December 2024
Department of Pharmacy Practice & Science, Center for the Advancement of Pharmacy Practice, University of Kentucky, 789 S. Limestone, Lexington, KY 40508, USA. Electronic address:
Introduction: This study uses the Exploration, Preparation, Implementation, and Sustainment (EPIS) model to retrospectively describe the mail-based overdose education and naloxone distribution (OEND) program developed in collaboration with the Kentucky Department of Corrections (DOC) for use in the HEALing Communities Study in Kentucky (HCS-KY) and details the reach of this innovative delivery model.
Methods: HCS-KY is a community-engaged cluster-randomized trial assessing the effects of implementing evidence-based practices, including OEND, on overdose death reduction across 16 communities highly impacted by the opioid epidemic in Kentucky. The study launch coincided with the COVID-19 pandemic.
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