|Titre :||Naloxone distribution and possession following a large-scale naloxone programme (2019)|
|Auteurs :||D. MADAH-AMIRI ; L. GJERSING ; T. CLAUSEN|
|Type de document :||Article : Périodique|
|Dans :||Addiction (Vol.114, n°1, January 2019)|
|Article en page(s) :||92-100|
|Note générale :||Commentary: Beyond saturation. Bennett A.S., Elliott L., Wolfson-Stofko B., p. 101-102|
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus TOXIBASENALOXONE ; PREVENTION ; SURDOSE ; PROGRAMME ; OPIOIDES ; HEROINE ; STRUCTURE DE PROXIMITE ; ETUDE TRANSVERSALE ; DIFFUSION DES PRODUITS
AIMS: To examine uptake following a large-scale naloxone programme by estimating distribution rates since programme initiation and the proportion among a sample of high-risk individuals who had attended naloxone training, currently possessed or had used naloxone. We also estimated the likelihood of naloxone possession and use as a function of programme duration, individual descriptive and substance use indicators.
DESIGN: (1) Distribution data (June 2014-August 2017) and date of implementation for each city and (2) a cross-sectional study among a sample of illicit substance users interviewed September 2017.
SETTING: Seven Norwegian cities.
PARTICIPANTS: A total of 497 recruited users of illegal opioids and/or central stimulants.
MEASUREMENTS: Primary outcomes: naloxone possession and use. Random-intercepts logistic regression models (covariates: male, age, homelessness/shelter use, overdose, incarceration, opioid maintenance treatment, income sources, substance use indicators, programme duration).
FINDINGS: Overall, 4631 naloxone nasal sprays were distributed in the two pilot cities, with a cumulative rate of 495 per 100 000 population. In the same two cities, among high-risk individuals, 44% and 62% reported current naloxone possession. The possession rates of naloxone corresponded well to the duration of each participating city's distribution programme. Overall, in the six distributing cities, 58% reported naloxone training, 43% current possession and 15% naloxone use. The significant indicators for possession were programme duration [adjusted odds ratios (aOR) = 1.44, 95% confidence interval (CI = 0.82-2.37], female gender (aOR = 1.97, 95% CI = 1.20-3.24) and drug-dealing (aOR = 2.36, 95% CI = 1.42-3.93). The significant indicators for naloxone use were programme duration (aOR = 1.49 95%, CI = 1.15-1.92), homelessness/shelter use (aOR = 2.06, 95% CI = 1.02-4.17), opioid maintenance treatment (OMT) (aOR = 2.07, 95% CI = 1.13-3.78), drug-dealing (aOR = 2.40, 95% CI = 1.27-4.54) and heroin injecting (aOR = 2.13, 95% CI = 1.04-4.38).
CONCLUSIONS: A large-scale naloxone programme in seven Norwegian cities with a cumulative distribution rate of 495 per 100 000 population indicated good saturation in a sample of high-risk individuals, with programme duration in each city as an important indicator for naloxone possession and use.
|Domaine :||Autres substances / Other substances ; Drogues illicites / Illicit drugs|
|Refs biblio. :||36|
|Affiliation :||Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway|