Naloxone distribution and possession following a large-scale naloxone programme
Naloxone distribution and possession following a large-scale naloxone programme
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DOI：
10.1111/add.14425
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发表时间：
2019-01-01
期刊：
影响因子：
6
通讯作者：
Clausen, Thomas
中科院分区：
文献类型：
--
作者：
Madah-Amiri, Desiree;Gjersing, Linn;Clausen, Thomas
目的通过估计自方案启动以来的分布率以及参加过纳洛酮培训、目前拥有或使用过纳洛酮的高风险个体样本的比例，检查大规模纳洛酮方案后的摄取情况。我们还估计了纳洛酮拥有和使用的可能性，作为程序持续时间，个人描述和物质使用指标的函数。设计（1）每个城市的分布数据（2014年6月至2017年8月）和实施日期，以及（2）2017年9月采访的非法药物使用者样本的横断面研究。挪威七个城市共有497人招募了非法阿片类药物和/或中枢兴奋剂的使用者。主要结果：纳洛酮的拥有和使用。随机截取logistic回归模型（协变量：男性、年龄、无家可归/庇护所使用、过量、监禁、阿片类药物维持治疗、收入来源、药物使用指标、方案持续时间）。结果总体而言，4631纳洛酮鼻喷雾剂分布在两个试点城市，每10万人口的累积率为495。在这两个城市，在高风险人群中，44%和62%的人报告目前拥有纳洛酮。纳洛酮的拥有率与每个参与城市的分配计划的持续时间相对应。总体而言，在六个分布城市中，58%的人报告接受过纳洛酮培训，43%的人目前拥有纳洛酮，15%的人使用纳洛酮。持有毒品的显著性指标为项目持续时间[校正比值比（aOR）= 1.44，95%可信区间（CI = 0.82-2.37）]、女性（aOR = 1.97，95%CI = 1.20-3.24）和毒品交易（aOR = 2.36，95%CI = 1.42-3.93）。纳洛酮使用的重要指标是程序持续时间（aOR = 1.49 95%，CI = 1.15-1.92），无家可归/庇护所使用（aOR = 2.06，95% CI = 1.02-4.17），阿片类药物维持治疗（OMT）吸毒（aOR = 2.40，95% CI = 1.27-4.54）和海洛因注射（aOR = 2.13，95% CI = 1.04-4.38）。结论：在挪威7个城市开展的大规模纳洛酮项目中，累积分布率为每10万人495例，表明高风险个体样本饱和度良好，每个城市的项目持续时间是纳洛酮拥有和使用的重要指标。
Aims To examine uptake following a large-scale naloxone programme by estimating distribution rates since programme initiation and the proportion among a sample of high-risk individuals who had attended naloxone training, currently possessed or had used naloxone. We also estimated the likelihood of naloxone possession and use as a function of programme duration, individual descriptive and substance use indicators. Design (1) Distribution data (June 2014-August 2017) and date of implementation for each city and (2) a cross-sectional study among a sample of illicit substance users interviewed September 2017. Setting Seven Norwegian cities. Participants A total of 497 recruited users of illegal opioids and/or central stimulants. Measurements Primary outcomes: naloxone possession and use. Random-intercepts logistic regression models (covariates: male, age, homelessness/shelter use, overdose, incarceration, opioid maintenance treatment, income sources, substance use indicators, programme duration). Findings Overall, 4631 naloxone nasal sprays were distributed in the two pilot cities, with a cumulative rate of 495 per 100 000 population. In the same two cities, among high-risk individuals, 44% and 62% reported current naloxone possession. The possession rates of naloxone corresponded well to the duration of each participating city's distribution programme. Overall, in the six distributing cities, 58% reported naloxone training, 43% current possession and 15% naloxone use. The significant indicators for possession were programme duration [adjusted odds ratios (aOR) = 1.44, 95% confidence interval (CI = 0.82-2.37], female gender (aOR = 1.97, 95% CI = 1.20-3.24) and drug-dealing (aOR = 2.36, 95% CI = 1.42-3.93). The significant indicators for naloxone use were programme duration (aOR = 1.49 95%, CI = 1.15-1.92), homelessness/shelter use (aOR = 2.06, 95% CI = 1.02-4.17), opioid maintenance treatment (OMT) (aOR = 2.07, 95% CI = 1.13-3.78), drug-dealing (aOR = 2.40, 95% CI = 1.27-4.54) and heroin injecting (aOR = 2.13, 95% CI = 1.04-4.38). Conclusions A large-scale naloxone programme in seven Norwegian cities with a cumulative distribution rate of 495 per 100 000 population indicated good saturation in a sample of high-risk individuals, with programme duration in each city as an important indicator for naloxone possession and use.