Bridging Emergency and Prevention: A Systematic Review of Take-Home Naloxone Programs.

Abstract

Background: Drug overdose deaths have been drastically rising in the past decade. Healthcare providers need to continuously innovate practices to provide historically underserved patients with access to harm reduction. The purpose of this study is to identify previously implemented take-home naloxone (THN) interventions to review outcomes and implementation strategies across different organizations in the United States. This review provides guidance to assist in developing, shaping, and evaluating benchmarks for other emergency departments (EDs).

Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this systematic review was conducted using PubMed, CINAHL Ultimate, and PsycInfo. This study used a two-concept search strategy with naloxone and ED subject headings to identify peer-reviewed articles with primary data from an ED-based THN intervention. The data were extracted using a tool developed by the author and comprised of three main categories: sample, components, and delivery.

Results: After screening for inclusion, a total of 10 articles were retained in the final sample. Studies varied by administration credibility based on the delivery of the overdose education and the degree of follow-up after discharge. While each study delivered naloxone, the programs across all sites packaged several different intervention components into the THN.

Conclusions: Study implementers should be aware of the cost, technological, and political feasibility of each component of the program. Specifically, funding has consistently been listed as a barrier to implementation. It is recommended that study teams become interdisciplinary and include voices from multiple departments within the healthcare system, as well as in partnership with local community organizations.