Higher levels of naloxone protection are associated with lower risk-taking: A longitudinal analysis of New York City residents using unprescribed opioids

IF 3.5 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2026-01-01 Epub Date: 2025-11-27 DOI:10.1016/j.drugalcdep.2025.112989

Luther Elliott , Adrian Harris , Dev Crasta , Melody S. Goodman , Yuyu Chen , Saba Rouhani , David Frank , Jemar R. Bather , Alex S. Bennett

{"title":"Higher levels of naloxone protection are associated with lower risk-taking: A longitudinal analysis of New York City residents using unprescribed opioids","authors":"Luther Elliott , Adrian Harris , Dev Crasta , Melody S. Goodman , Yuyu Chen , Saba Rouhani , David Frank , Jemar R. Bather , Alex S. Bennett","doi":"10.1016/j.drugalcdep.2025.112989","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To apply risk compensation theory to naloxone peer access and evaluate whether reported naloxone <em>protection</em>—having naloxone and someone to administer it present when using unprescribed opioids—correlated with greater opioid overdose risk behaviors.</div></div><div><h3>Methods</h3><div>Longitudinal cohort of 422 NYC residents using unprescribed opioids who completed at least three monthly surveys over 24 months. Mixed-effects models estimated unadjusted and adjusted associations between naloxone protection and both opioid risk and overdose events and were used to test whether race/ethnicity and gender modified the relationship between naloxone protection and risk behaviors.</div></div><div><h3>Results</h3><div>Being protected 75 % of the time or more was identified as a meaningful cutoff in the sample and was associated with fewer opioid risk behaviors and overdose events. Race/ethnicity, but not gender, was found to be a significant effect modifier of naloxone protection.</div></div><div><h3>Conclusions</h3><div>Findings indicate no support for the risk compensation-derived hypothesis that people who use opioids while protected by naloxone pursue more overdose-associated risk behaviors than those unprotected.</div></div><div><h3>Policy implications</h3><div>Concerns about how naloxone may disinhibit people who use opioids, leading to greater risk-taking, appear unfounded, reaffirming the importance of universal naloxone access.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112989"},"PeriodicalIF":3.5000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug and alcohol dependence","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0376871625004429","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To apply risk compensation theory to naloxone peer access and evaluate whether reported naloxone protection—having naloxone and someone to administer it present when using unprescribed opioids—correlated with greater opioid overdose risk behaviors.

Methods

Longitudinal cohort of 422 NYC residents using unprescribed opioids who completed at least three monthly surveys over 24 months. Mixed-effects models estimated unadjusted and adjusted associations between naloxone protection and both opioid risk and overdose events and were used to test whether race/ethnicity and gender modified the relationship between naloxone protection and risk behaviors.

Results

Being protected 75 % of the time or more was identified as a meaningful cutoff in the sample and was associated with fewer opioid risk behaviors and overdose events. Race/ethnicity, but not gender, was found to be a significant effect modifier of naloxone protection.

Conclusions

Findings indicate no support for the risk compensation-derived hypothesis that people who use opioids while protected by naloxone pursue more overdose-associated risk behaviors than those unprotected.

Policy implications

Concerns about how naloxone may disinhibit people who use opioids, leading to greater risk-taking, appear unfounded, reaffirming the importance of universal naloxone access.

查看原文本刊更多论文

更高水平的纳洛酮保护与更低的风险相关：对使用非处方阿片类药物的纽约市居民的纵向分析

目的将风险补偿理论应用于纳洛酮的同行获取，并评估报告的纳洛酮保护（非处方阿片类药物使用时存在纳洛酮和给药者）是否与阿片类药物过量风险行为增加相关。方法对422名使用非处方阿片类药物的纽约市居民进行纵向队列研究，这些居民在24个月内完成了至少三个月的调查。混合效应模型估计了纳洛酮保护与阿片类药物风险和过量事件之间未经调整和调整的关联，并用于测试种族/民族和性别是否改变了纳洛酮保护与风险行为之间的关系。结果在样本中，75%或更多的时间受到保护被确定为有意义的临界值，并与较少的阿片类药物风险行为和过量事件相关。种族/民族，而非性别，被发现是纳洛酮保护的显著影响因素。结论：研究结果不支持风险补偿衍生的假设，即使用阿片类药物并接受纳洛酮保护的人比未接受纳洛酮保护的人有更多的过量相关风险行为。政策影响对纳洛酮如何使阿片类药物使用者失去抑制，从而导致更大风险的担忧似乎是没有根据的，这重申了普遍获得纳洛酮的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.