Prison-based Naloxone-on-release RCT to reduce drugs-related deaths

基于监狱的纳洛酮释放随机对照试验可减少与毒品相关的死亡

• 批准号: MC_EX_G0800012
• 负责人: Mahesh Parmar
• 金额: $ 76.63万
• 依托单位: MRC Clinical Trials Unit
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2008
• 资助国家: 英国
• 起止时间: 2008 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MC_EX_G0800012
• 关键词: Prison; based; Naloxone; release; RCT

Opiate overdose has become one of the main causes of death for young people and early adults. More than three-quarters of overdoses are accidental (associated with errors in the calculation of the dose, or lack of tolerance to the drug effect after a period of abstinence), and are not associated with suicidal intent. Most overdoses occur the user s own, or a friend?s home in the company of friends and peers, and involve heroin or other opiates. Consequently, many deaths could potentially be prevented by appropriate management of overdose by peers or family, who could administer a life saving emergency intramuscular injection of Naloxone whilst awaiting the arrival of emergency medical services. Naloxone is a total antidote to opiate overdose. Most opiate overdoses take place away from healthcare settings, especially in private dwellings or among the homeless. This makes fast and effective treatment somewhat problematic. The overdose must be identified, an ambulance must be called, the ambulance must find the location, and only then will the patient be treated with naloxone. Furthermore, the location of the overdose victim may be hard to find or difficult to access. Ambulance crews may also be reluctant to enter some of these areas without police support. These and other factors can contribute to further delay in the provision of vital treatment. Delay in emergency treatment contributes to the high mortality of opiate addicts due to accidental overdose. Antidote injection of Naloxone is now routinely carried in ambulances. The proposed trial involves the next step in the transfer of this technology: placement of emergency Naloxone in the hands of the potential drug user so that if they do overdose there is an opportunity for friends or family to prevent their death between when an ambulance is called and its arrival.

阿片类药物过量已成为年轻人和早期成年人死亡的主要原因之一。超过四分之三的药物过量是意外的（与剂量计算错误有关，或者在一段时间的禁欲后对药物作用缺乏耐受性），并且与自杀意图无关。大多数药物过量发生在用户自己或朋友身上？在朋友和同龄人的陪伴下，并涉及海洛因或其他阿片类药物。因此，许多死亡可以通过同伴或家人对过量药物的适当管理来预防，他们可以在等待紧急医疗服务的到来时进行救命的纳洛酮紧急肌内注射。纳洛酮是阿片类药物过量的解毒剂。大多数阿片类药物过量发生在远离医疗机构的地方，特别是在私人住宅或无家可归者中。这使得快速和有效的治疗有点问题。必须确定过量，必须呼叫救护车，救护车必须找到位置，只有这样，患者才能接受纳洛酮治疗。此外，过量受害者的位置可能很难找到或难以接近。救护人员也可能不愿意在没有警察支持的情况下进入其中一些地区。这些因素和其他因素可能会进一步拖延提供重要治疗。由于意外过量，延误紧急治疗导致阿片类药物成瘾者的高死亡率。纳洛酮的解毒剂注射液现在通常由救护车运送。拟议的试验涉及这项技术转让的下一步：将紧急纳洛酮放在潜在吸毒者手中，以便如果他们过量服用，朋友或家人有机会在救护车被呼叫和到达之间防止他们死亡。

项目成果

Take-home emergency naloxone to prevent heroin overdose deaths after prison release: rationale and practicalities for the N-ALIVE randomized trial.

带回家的紧急纳洛酮可预防出狱后海洛因过量死亡：N-ALIVE 随机试验的基本原理和实用性。

• DOI: 10.1007/s11524-013-9803-1
• 发表时间: 2013
• 期刊: bulletin of the New York Academy of Medicine
• 作者: Strang J

Randomized controlled pilot trial of naloxone-on-release to prevent post-prison opioid overdose deaths.

• DOI: 10.1111/add.13668
• 发表时间: 2017-03
• 期刊: Addiction (Abingdon, England)
• 作者: Parmar MK;Strang J;Choo L;Meade AM;Bird SM
• 通讯作者: Bird SM

External data required timely response by the Trial Steering-Data Monitoring Committee for the NALoxone InVEstigation (N-ALIVE) pilot trial.

• DOI: 10.1016/j.conctc.2017.01.006
• 发表时间: 2017-03
• 期刊: Contemporary clinical trials communications
• 影响因子: 1.5
• 作者: Bird SM;Strang J;Ashby D;Podmore J;Robertson JR;Welch S;Meade AM;Parmar MKB
• 通讯作者: Parmar MKB