Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: a survey of street-recruited injectors in the San Francisco Bay Area
Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: a survey of street-recruited injectors in the San Francisco Bay Area
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DOI：
10.1093/jurban/jtg032
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发表时间：
2003-06-01
影响因子：
6.6
通讯作者：
Edlin, BR
中科院分区：
文献类型：
--
作者：
Seal, KH;Downing, M;Edlin, BR
纳洛酮是一种可注射的阿片类拮抗剂，可立即逆转阿片类药物过量并防止过量死亡。我们试图确定注射吸毒者（ID Us）对处方带回家纳洛酮的态度。在1999年11月至2000年2月期间，我们调查了82名来自加州旧金山湾区的街头招募的注射吸毒者，他们都经历过一次或多次海洛因过量事件。我们使用了一份问卷，其中包括结构化和开放式的问题。大多数答复者（89%）目睹了过量服用，90%的人报告最初试图采取非专业药物，以帮助同伴生存。只有51%的人报告说，在最后一次目睹吸毒过量时曾寻求紧急援助（拨打911），大多数人由于担心警察介入而犹豫不决。在接受调查的ID u中，87%强烈赞成参加过量用药管理培训计划，接受纳洛酮带回家和复苏技术培训。然而，受访者表达了各种各样的担忧态度。如果提供纳洛酮，35%的人预测他们可能会放心使用更多的海洛因，62%的人可能不太愿意为过量使用海洛因拨打911,30%的人可能会在纳洛酮复苏后离开过量使用海洛因的受害者，46%的人可能无法劝阻受害者再次使用海洛因以减轻纳洛酮引起的戒断症状。给急救人员开带回家的纳洛酮，并对其使用和复苏技术进行培训，这可能是一种挽救生命的、以同伴为基础的获取紧急服务的辅助手段。然而，需要在过量用药管理培训计划中强调克服与使用纳洛酮带回家相关的潜在风险的策略。
Naloxone, an injectable opiate antagonist, can immediately reverse an opiate overdose and prevent overdose death. We sought to determine injection drug users' (ID Us) attitudes about being prescribed take-home naloxone. During November 1999 to February 2000, we surveyed 82 street-recruited IDUs from the San Francisco Bay Area of California who had experienced one or more heroin overdose events. We used a questionnaire that included structured and open-ended questions. Most respondents (89%) had witnessed an overdose, and 90% reported initially attempting lay remedies in an effort to help companions survive. Only 51% reported soliciting emergency assistance (calling 911) for the last witnessed overdose, with most hesitating due to fear of police involvement. Of ID Us surveyed, 87% were strongly in favor of participating in an overdose management training program to receive take-home naloxone and training in resuscitation techniques. Nevertheless, respondents expressed a variety of concerning attitudes. If provided naloxone, 35% predicted that they might feel comfortable using greater amounts of heroin, 62% might be less inclined to call 911 for an overdose, 30% might leave an overdose victim after naloxone resuscitation, and 46% might not be able to dissuade the victim from using heroin again to alleviate withdrawal symptoms induced by naloxone. Prescribing take-home naloxone to ID Us with training in its use and in resuscitation techniques may represent a life-saving, peer-based adjunct to accessing emergency services. Nevertheless, strategies for overcoming potential risks associated with the use of take-home naloxone would need to be emphasized in an overdose management training program.