Gaps in Naloxone Ownership among People who Inject Drugs during the Fentanyl Wave of the Opioid Overdose Epidemic in New York City, 2018

IF 2.8 3区医学 Q2 SUBSTANCE ABUSE

Substance abuse Pub Date : 2022-05-26 DOI:10.1080/08897077.2022.2074597

A. Rivera, Michelle L. Nolan, D. Paone, Sidney A. Carrillo, S. Braunstein

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引用次数: 4

Abstract

Background: Community distribution of naloxone, a medication that reverses opioid overdose, is an effective public health strategy to prevent overdose deaths. However, data are limited on who has naloxone during the current fentanyl wave of the opioid overdose epidemic in the United States. We aim to determine correlates of naloxone ownership among a community sample of people who inject drugs (PWID) from New York City (NYC). Methods: Data were drawn from the National HIV Behavioral Surveillance Study among PWID. Participants were recruited via respondent-driven sampling. Eligible participants completed an interviewer-administered survey. Log-linked Poisson regression was used to determine adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) current naloxone ownership. Results: Of 503 PWID, 60% currently owned naloxone. In the past 12 months, 74% witnessed an opioid overdose and 25% experienced one. Those who experienced current homelessness were less likely to own naloxone (aPR: 0.79; 95% CI: 0.68, 0.91), as were those who had been recently incarcerated (aPR: 0.83; 95% CI: 0.71, 0.97). Respondents who reported recent known or possible fentanyl use were more likely to own naloxone (aPR: 1.23; 95% CI: 1.07, 1.43) as were those who experienced an opioid overdose in the past 12 months (aPR: 1.33; 95% CI: 1.15, 1.53). Conclusions: The prevalence of naloxone ownership among PWID in NYC was high, potentially due to widespread community naloxone distribution programs; however, gaps in naloxone ownership existed. Interventions that further ease access to naloxone, such as reclassifying naloxone as an over-the-counter medication and making it available “off the shelf,” should be considered. More research is needed to identify barriers to access, uptake, and sustained possession within this group to maximize the impact of naloxone distribution during the ongoing fentanyl wave of the opioid overdose epidemic.

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2018年纽约市阿片类药物过量流行的芬太尼浪潮中注射药物的人对纳洛酮所有权的差距

背景：社区分发纳洛酮是一种逆转阿片类药物过量的药物，是预防过量死亡的有效公共卫生策略。然而，在当前美国阿片类药物过量流行的芬太尼浪潮中，关于谁服用纳洛酮的数据有限。我们的目的是在纽约市注射毒品（PWID）的社区样本中确定纳洛酮所有权的相关性。方法：数据来源于PWID中的全国HIV行为监测研究。参与者是通过受访者驱动的抽样招募的。符合条件的参与者完成了面试官管理的调查。对数关联泊松回归用于确定调整后的流行率（aPR）和当前纳洛酮所有权的95%置信区间（CI）。结果：在503名PWID中，60%目前拥有纳洛酮。过去12 几个月来，74%的人目睹了阿片类药物过量，25%的人经历过。那些目前无家可归的人不太可能拥有纳洛酮（aPR:0.79；95%CI:0.68，0.91），最近被监禁的人也不太可能（aPR=0.83；95%CI:0.71，0.97）。报告最近已知或可能使用芬太尼的受访者更有可能拥有纳洛酮月（aPR:1.33；95%CI:1.15,1.53）。结论：纽约市PWID中纳洛酮拥有率较高，可能是由于广泛的社区纳洛酮分发计划；然而，纳洛酮所有权方面存在差距。应该考虑采取进一步简化纳洛酮使用的干预措施，例如将纳洛酮重新归类为非处方药，并使其“现成”。需要更多的研究来确定这一群体中获取、吸收和持续持有的障碍，以最大限度地发挥纳洛酮在阿片类药物过量流行的芬太尼浪潮中的影响。

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来源期刊

Substance abuse SUBSTANCE ABUSE-

CiteScore

5.90

自引率

2.90%

发文量

审稿时长

>12 weeks

期刊介绍： Now in its 4th decade of publication, Substance Abuse journal is a peer-reviewed journal that serves as the official publication of Association for Medical Education and Research in Substance Abuse (AMERSA) in association with The International Society of Addiction Medicine (ISAM) and the International Coalition for Addiction Studies in Education (INCASE). Substance Abuse journal offers wide-ranging coverage for healthcare professionals, addiction specialists and others engaged in research, education, clinical care, and service delivery and evaluation. It features articles on a variety of topics, including: Interdisciplinary addiction research, education, and treatment Clinical trial, epidemiology, health services, and translation addiction research Implementation science related to addiction Innovations and subsequent outcomes in addiction education Addiction policy and opinion International addiction topics Clinical care regarding addictions.