Acceptability of prison-based take-home naloxone programmes among a cohort of incarcerated men with a history of regular injecting drug use
Acceptability of prison-based take-home naloxone programmes among a cohort of incarcerated men with a history of regular injecting drug use
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DOI：
10.1186/s12954-018-0255-5
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发表时间：
2018-09-21
影响因子：
4.4
通讯作者：
Stoove, Mark
中科院分区：
文献类型：
--
作者：
Curtis, Michael;Dietze, Paul;Stoove, Mark
背景：纳洛酮带回家（THN）规划是一项基于证据的阿片类药物过量预防举措。出狱后阿片类药物过量的风险增加意味着从拘留中释放为THN倡议提供了理想的机会。然而，澳大利亚囚犯是否会利用这类项目尚不得而知。我们在澳大利亚维多利亚州的一组有常规注射吸毒史的男性囚犯中检查了THN的可接受性。方法：样本包括来自监狱和过渡健康（PATH）队列研究的380名男性；他们都报告在入狱前6个月有规律的注射过量。在释放前的基线访谈中，我们问了四个关于THN的问题，包括参与者是否愿意参加基于监狱的THN。我们描述了对这些问题的回答，以及入狱前和入狱期间因素与在出狱前参加71-IN培训的意愿之间的关系。结果：大多数参与者（81%）表示愿意在释放前接受THN培训。如果接受过THN的训练，大多数人愿意用THN使朋友复苏（94%），并且接受训练过的同伴使用THN使其复苏（91%）。距第一次注射超过10年（调整比值比[AOR] 2.22, 95%Cl 1.03-4.77），在过去5年中目睹过阿片类药物过量（AOR 2.53, 95%Cl 1.32-4.82），曾经在监狱接受过酒精或其他药物治疗（AOR 2.41, 95%Cl 1.14-5.07），以及在当前服刑期间注射毒品（AOR 4.45, 95%Cl 1.73-11.43）与愿意参加监狱THN方案的几率显著相关。没有说明他们是否在服刑期间注射（AOR 0.37, 95%Cl 0.18-0.77）与愿意参加监狱THN培训的几率降低有关。结论：我们的研究结果表明，在维多利亚州，有常规IDU史的男性囚犯绝大多数愿意在释放前参加THN培训。与是否愿意参与监狱THN方案有关的因素提供了见解，有助于支持THN方案的实施和采用，以减少释放后期间阿片类药物过量死亡。
Background: Take-home naloxone (THN) programmes are an evidence-based opioid overdose prevention initiative. Elevated opioid overdose risk following prison release means release from custody provides an ideal opportunity for THN initiatives. However, whether Australian prisoners would utilise such programmes is unknown. We examined the acceptability of THN in a cohort of male prisoners with histories of regular injecting drug use (IDU) in Victoria, Australia.Methods: The sample comprised 380 men from the Prison and Transition Health (PATH) Cohort Study; all of whom reported regular IDU in the 6 months prior to incarceration. We asked four questions regarding THN during the pre-release baseline interview, including whether participants would be willing to participate in prison-based THN. We describe responses to these questions along with relationships between before- and during-incarceration factors and willingness to participate in 71-IN training prior to release from prison.Results: Most participants (81%) reported willingness to undertake THN training prior to release. Most were willing to resuscitate a friend using THN if they were trained (94%) and to be revived by a trained peer (91%) using THN. More than 10 years since first injection (adjusted odds ratio [AOR] 2.22, 95%Cl 1.03-4.77), having witnessed an opioid overdose in the last 5 years (AOR 2.53, 95%Cl 1.32-4.82), having ever received alcohol or other drug treatment in prison (AOR 2.41, 95%Cl 1.14-5.07) and injecting drugs during the current prison sentence (AOR 4.45, 95%Cl 1.73-11.43) were significantly associated with increased odds of willingness to participate in a prison THN programme. Not specifying whether they had injected during their prison sentence (AOR 0.37, 95%Cl 0.18-0.77) was associated with decreased odds of willingness to participate in a prison THN training.Conclusion: Our findings suggest that male prisoners in Victoria with a history of regular IDU are overwhelmingly willing to participate in THN training prior to release. Factors associated with willingness to participate in prison THN programmes offer insights to help support the implementation and uptake of THN programmes to reduce opioid-overdose deaths in the post-release period.