Elsevier

Drug and Alcohol Dependence

Volume 173, 1 April 2017, Pages 17-23
Drug and Alcohol Dependence

Full length article
Rapid widespread distribution of intranasal naloxone for overdose prevention

https://doi.org/10.1016/j.drugalcdep.2016.12.013Get rights and content
Under a Creative Commons license
open access

Highlights

  • A government-supported take-home naloxone program was implemented in Norway.

  • Distribution rates met suggested coverage rates for large-scale naloxone programs.

  • Participants exhibited known risk factors for overdosing.

  • The intervention produced widespread distribution of naloxone to at-risk groups.

Abstract

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.

Keywords

Opioid
Overdose prevention
Naloxone
Implementation
Public health
Policy

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