Naloxone laws facilitate the establishment of overdose education and naloxone distribution programs in the United States
Naloxone laws facilitate the establishment of overdose education and naloxone distribution programs in the United States
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DOI：
10.1016/j.drugalcdep.2018.04.004
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发表时间：
2018-07-01
影响因子：
4.2
通讯作者：
Kral, Alex H.
中科院分区：
文献类型：
--
作者：
Lambdin, Barrot H.;Davis, Corey S.;Kral, Alex H.
背景资料：美国阿片类药物过量危机持续恶化。通过及时给予纳洛酮，阿片类药物过量死亡是完全可以预防的。自2001年以来，许多州通过了法律，为实施过量教育和纳洛酮分配(OEND)计划创造有利环境。我们评估了州级纳洛酮法律及其条款是否促进了美国OEND项目的实施。方法：从2000年到2014年，我们利用了WestLaw法律数据库、处方药滥用政策系统、减少伤害联盟的OEND数据库、国家卫生统计中心和美国人口普查等5个数据来源。采用具有稳健方差的随机效应Logistic回归模型，检验截至2014年纳洛酮获得性法规及其条款与OEND项目实施之间的关系。结果：截至2014年底，8%的县实施了OEND项目。州内有纳洛酮法律的县(AOR=28.98；p<；0.001)或六项法律中的任何一项--第三方(AOR=12.86；p=0.001)、常规(AOR=11.45；p<；0.001)、持有(AOR=45.97；p<；0.001)、处方者豁免(AOR=5.19；p=0.007)、配药员豁免(AOR=3.5；p=0.028)或外行配药(AOR=12.91；P=0.001)-与没有法律或具体规定的州内的县相比，在这些州内实施自愿戒酒计划的几率分别增加。结论：我们的发现表明，纳洛酮法律促进了自愿戒毒计划的实施。由于只有8%的县有OEND计划，未来的研究应该调查改善OEND计划执行情况的策略。
Background: The opioid overdose crisis in the United States continues to worsen. Opioid overdose mortality is entirely preventable with timely administration of naloxone. Since 2001, many states have passed laws to create an enabling environment for the implementation of overdose education and naloxone distribution (OEND) programs. We assessed whether state-level naloxone laws and their provisions stimulated the implementation of OEND programs in the United States.Methods: Covering the period from 2000 to 2014, we utilized five data sources including the Westlaw legal database, the Prescription Drug Abuse Policy System, the Harm Reduction Coalition's OEND database, National Center of Health Statistics and the United States Census. Random effects logistic regression models with robust variances were used to examine the association of naloxone access laws and their provisions with OEND program implementation as of 2014.Results: At the end of 2014, 8% of counties had OEND programs implemented within them. Counties within states that had a naloxone law (aOR = 28.98; p < 0.001) or a law with any one of the six provisions - third party (aOR = 12.86; p = 0.001), standing order (aOR = 11.45; p < 0.001), possession (aOR = 45.97; p < 0.001), prescriber immunity (aOR = 5.19; p = 0.007), dispenser immunity (aOR = 3.50; p = 0.028) or layperson dispensing (aOR = 12.91; p = 0.001) - had increased odds of an OEND program implemented within them, compared to counties within states without a law or specific provision, respectively.Conclusion: Our findings suggest that naloxone laws facilitated the implementation of OEND programs. With only 8% of counties having an OEND program within them, future studies should investigate strategies to improve the implementation of OEND programs.