Engagement in a National Naloxone Program among People Who Inject Drugs
HIGHLINGHTS
- Access
to naloxone among PWID increased significantly from 8% in 2011–2012 to 32% in
2013–2014.
- Carriage
of naloxone decreased significantly from 16% in 2011–2012 to 5% in 2013–2014.
- Community
services and prisons were equally efficient at targeting their naloxone
supplies.
BACKGROUND:
Availability
of the opioid antagonist naloxone for lay administration has grown
substantially since first proposed in 1996. Gaps remain, though, in our
understanding of how people who inject drugs (PWID) engage with naloxone
programmes over time.
AIMS:
This paper
aimed to address three specific evidence gaps: the extent of naloxone supply to
PWID; supply-source (community or prisons); and the carriage of naloxone among
PWID.
MATERIALS AND METHODS:
Analysis
of Scotland's Needle Exchange Surveillance Initiative (NESI) responses in 2011-2012
and 2013-2014 was undertaken with a specific focus on the extent of Scotland's
naloxone supply to PWID; including by source (community or prisons); and on the
carriage of naloxone. Differences in responses between the two surveys were
measured using Chi-square tests together with 95% confidence intervals for
rate-differences over time.
RESULTS:
The
proportion of NESI participants who reported that they had been prescribed
naloxone within the last year increased significantly from 8% (175/2146; 95%
CI: 7-9%) in 2011-2012 to 32% (745/2331; 95% CI: 30% to 34%) in 2013-2014. In
contrast, the proportion of NESI participants who carried naloxone with them on
the day they were interviewed decreased significantly from 16% (27/169; 95% CI:
10% to 22%) in 2011-2012 to 5% (39/741; 95% CI: 4% to 7%) in 2013-2014.
CONCLUSIONS:
The
supply of naloxone to PWID has increased significantly since the introduction
of a National Naloxone Programme in Scotland in January 2011. In contrast,
naloxone carriage is low and decreased between the two NESI surveys; this area
requires further investigation.
- 1Health Protection Scotland, Meridian Court, Cadogan Street, Glasgow G2 6QE, UK; Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK. Electronic address: andrew.mcauley@nhs.net.
- 2School of Media, Culture and Society, University of the West of Scotland, Paisley PA1 2BE, UK.
- 3MRC Biostatistics Unit, Cambridge CB2 0SR, UK; Department of Mathematics and Statistics, Strathclyde University, Glasgow G1 1XH, UK.
- 4Health Protection Scotland, Meridian Court, Cadogan Street, Glasgow G2 6QE, UK; Institute for Applied Health Research, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK.
- Drug Alcohol Depend. 2016 Mar 3. pii: S0376-8716(16)00106-X. doi: 10.1016/j.drugalcdep.2016.02.031.
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