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Traylor DO. From Response to Prevention: Enhancing EMS Impact With Harm Reduction and HIV Education. Cureus 2024; 16:e68884. [PMID: 39376841 PMCID: PMC11457950 DOI: 10.7759/cureus.68884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2024] [Indexed: 10/09/2024] Open
Abstract
EMS are crucial not only for immediate life-saving interventions but also for broader public health initiatives, particularly in harm reduction and HIV prevention. However, many EMS training programs lack comprehensive education and training in these areas, resulting in significant gaps in patient care and provider safety. As the opioid epidemic continues to devastate communities, the need for EMS personnel to be trained in harm reduction strategies, such as naloxone administration, and HIV prevention, has become increasingly urgent. Integrating harm reduction and HIV prevention into EMS training is essential for equipping first responders to effectively address the complex needs of individuals affected by addiction. This training is not only vital for improving public health outcomes but also for ensuring the safety and efficacy of EMS providers in their critical roles on the front lines. The evidence strongly supports the immediate inclusion of harm reduction and HIV prevention in EMS curricula to enhance care quality, reduce the spread of HIV, and combat the ongoing opioid crisis.
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Affiliation(s)
- Daryl O Traylor
- Public Health, A.T. Still University's (ATSU) College of Graduate Health Studies (CGHS), Mesa, USA
- Basic Sciences, University of the Incarnate Word School of Osteopathic Medicine, San Antonio, USA
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Fleißner S, Stöver H, Schäffer D. [Take-home naloxone: a building block of drug emergency prophylaxis in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:1035-1041. [PMID: 37233811 PMCID: PMC10465660 DOI: 10.1007/s00103-023-03705-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/19/2023] [Indexed: 05/27/2023]
Abstract
Naloxone is an opioid antagonist that reverses the (respiratory-paralyzing) effects of opioids in the body within minutes. Naloxone can therefore reduce opioid overdose deaths. Take-home naloxone (THN) is an intervention recommended by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the World Health Organization (WHO). It involves training opioid users and their relatives or friends in the use of naloxone and providing them with the drug in case of emergency.So far, THN has been implemented in Germany mainly by individual addiction support facilities. In order to fully exploit the potential of THN, it is necessary to establish the measure nationwide. In particular, THN can be included in the services offered in (low-threshold) addiction support facilities, in psychiatric facilities, in the context of opioid substitution treatment, and in the correctional system.This discussion article reviews the development of THN in Germany since 1998, highlights the difficulties and obstacles to its widespread implementation, and outlines how THN can succeed as an effective public health intervention in Germany. This is particularly relevant in view of the increasing number of drug-related deaths over the past 10 years.
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Affiliation(s)
- Simon Fleißner
- Institut für Suchtforschung Frankfurt (ISFF), University of Applied Sciences Frankfurt, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland.
| | - Heino Stöver
- Institut für Suchtforschung Frankfurt (ISFF), University of Applied Sciences Frankfurt, Nibelungenplatz 1, 60318, Frankfurt am Main, Deutschland
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Abstract
The transition process of release from prisons into the community is associated with high risks for users of opioids. Especially in the first 10-14 days in freedom, the risk of drug-related overdoses is extremely high, in the worst case with lethal outcome. There are two main medical strategies for the target group: on the one hand, medication-assisted treatment before, during and after incarceration, and on the other hand, edcuation about and acccess to naloxone as an antidote in case of opioid-related overdose. This article gives an overview of current numbers of drug-related deaths after release from prison in Germany and of scientific knowledge regarding the efficacy of medication-assisted treatment and naloxone provision for opioid users at the interface of custody and freedom. Finally, necessary interventions to avoid drug-related overdose with lethal consequences are described. For this purpose, a selective literature review was carried out and 16 crime agencies in Germany were contacted.
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Affiliation(s)
- Heino Stöver
- Frankfurt University of Applied Sciences, Institut für
Suchtforschung Frankfurt am Main (ISFF), Frankfurt am Main,
Germany
| | - IngoIlja Michels
- Frankfurt University of Applied Sciences, Institut für
Suchtforschung Frankfurt am Main (ISFF), Frankfurt am Main,
Germany
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Strang J. Take-Home Naloxone and the Prevention of Deaths from Heroin Overdose: Pursuing Strong Science, Fuller Understanding, Greater Impact. Eur Addict Res 2022; 28:161-175. [PMID: 34963112 DOI: 10.1159/000519939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND CONTEXT Realization of the life-saving potential of "take-home naloxone" has been a personal journey, but it has also been a collective journey. It has been a story of individual exploration and growth, and also a story of changes at a societal level. "Take-home naloxone" has matured since its first conceptualization a quarter of a century ago. It required recognition of the enormous burden of deaths from drug overdose (particularly heroin and other opioids), and also realization of critical clusterings (such as post-release from prison). It also required realization that, since many overdose deaths are witnessed, we can potentially prevent many deaths by mobilizing drug users themselves, their families, and the wider caring community to act as intervention workforce to give life-saving interim emergency care. Summary of Scope: This article explores 5 areas (many illustrations UK-based where the author works): firstly, the need for strong science; secondly, our improved understanding of opioid overdose and deaths; thirdly, the search for greater impact from our policies and interventions; fourthly, developing better forms of naloxone; and fifthly, examining the challenges still to be addressed. KEY MESSAGES "Take-home naloxone" is an exemplar of harm reduction with potential global impact - drug policy and practice for the public good. However, "having the potential" is not good enough - there needs to be actual implementation. This will be easier once the component parts of "take-home naloxone" are improved (better naloxone products, better training aids, revised legislation, and explicit funding support). Many improvements are already possible, but we hesitate about implementation. It is our responsibility to drive progress faster. With "take-home naloxone," we can be proud of what we have achieved, but we must also be humble about how much more we still need to do.
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Affiliation(s)
- John Strang
- National Addiction Centre, Kings College London, London, United Kingdom
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Naloxone in Correctional Facilities for the Prevention of Opioid Overdose Deaths. JOURNAL OF CORRECTIONAL HEALTH CARE 2021; 28:66-67. [PMID: 34967694 DOI: 10.1089/jchc.2021.29008.ncchc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Scott CK, Dennis ML, Grella CE, Mischel AF, Carnevale J. The impact of the opioid crisis on U.S. state prison systems. HEALTH & JUSTICE 2021; 9:17. [PMID: 34304335 PMCID: PMC8310396 DOI: 10.1186/s40352-021-00143-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/28/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Prior studies have documented limited use of medications to treat opioid use disorders (OUD) for people incarcerated within state prisons in the United States. Using the framework of the criminal justice OUD service cascade, this study interviewed representatives of prison systems in states most heavily impacted by opioid overdose regarding the provision of medications for OUD (MOUD). METHODS A stratified sampling strategy included states with high indicators of opioid-overdose deaths. Two sampling strata targeted states with: 1) OUD overdose rates significantly higher than the per capita national average; or 2) high absolute number of OUD overdose fatalities. Interviews were completed with representatives from 21 of the 23 (91%) targeted states in 2019, representing 583 prisons across these states. Interviews assessed service provision across the criminal justice OUD service cascade, including OUD screening, withdrawal management, MOUD availability and provision, overdose prevention, re-entry services, barriers, and needs for training and technical assistance. RESULTS MOUD (buprenorphine, methadone, or naltrexone) was available in at least one prison in approximately 90% of the state prison systems and all three medications were available in at least one prison in 62% of systems. However, MOUD provision was limited to subsets of prisons within these systems: 15% provided buprenorphine, 9% provided methadone, 36% provided naltrexone, and only 7% provided all three. Buprenorphine and methadone were most frequently provided to pregnant women or individuals already receiving these at admission, whereas naltrexone was primarily used at release. Funding was the most frequently cited barrier for all medications. CONCLUSION Study findings yield a complex picture of how, when, and to whom MOUD is provided across prisons within prison systems in states most heavily impacted by opioid overdose in the United States and have implications for expanding availability.
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Affiliation(s)
- Christy K. Scott
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
| | | | | | | | - John Carnevale
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
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Jamin D, Vanderplasschen W, Sys O, Jauffret-Roustide M, Michel L, Trouiller P, Neisa A, Homen M, Mendes V, Stöver H. "My first 48 hours out": drug users' perspectives on challenges and strategies upon release from prison. Harm Reduct J 2021; 18:32. [PMID: 33712032 PMCID: PMC7953692 DOI: 10.1186/s12954-021-00480-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 03/02/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Prisoners report much higher prevalence rates of drug use and more harmful consumption patterns than the general population. People who use drugs have above-average experiences with the criminal justice system in general, and the prison system and subsequent release situations in particular. Release from prison is associated with increased mortality rates among drug users due to the risk of overdose. The EU-funded project 'My first 48 hours out' aimed to address the gaps in continuity of care for long-term drug users in prison and upon release, with a special focus on drug user's perspectives on needs and challenges upon release. METHODS A multi-country (Belgium, France, Germany and Portugal) qualitative study was set up to explore drug users' perceptions of drug use and risk behaviour upon prison release, experiences of incarceration and release, and strategies to avoid risks when being released. In total, 104 prisoners and recently released persons with a history of drug use participated in semi-structured interviews and focus groups discussions on these topics. RESULTS Respondents pointed out that there are numerous challenges for people who use drugs when released from prison. Lack of stable housing and employment support were frequently mentioned, as well as complex administrative procedures regarding access to services, health insurance and welfare benefits. Besides structural challenges, individual issues may challenge social reintegration like 'old habits', mental health problems and disrupted social networks. As a result, (ex-)prisoners adopt individual strategies to cope with the risks and challenges at release. CONCLUSION Measures to prepare prisoners for release often do not focus on the individual and specific challenges of persons who use drugs. Psychosocial and medical support need to be improved and adjusted to drug users' needs inside and outside prison. To improve the quality and continuity of care around release, the perspectives and coping strategies of people who use drugs should be used to better address their needs and barriers to treatment.
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Affiliation(s)
- Daniela Jamin
- Institute for Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany.
| | | | - Orphée Sys
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Marie Jauffret-Roustide
- Cermes 3 (Inserm U988/CNRS UMR 8211/EHESS/), Université de Paris, Paris, France
- Baldy Center for Law and Social Policy, Buffalo University of Social Sciences, New York, USA
| | - Laurent Michel
- CESP, INSERM UMR1018, University Paris - Saclay, Pierre Nicole Centre, French Red Cross, Paris, France
| | - Philippe Trouiller
- CESP, INSERM UMR1018, University Paris - Saclay, Pierre Nicole Centre, French Red Cross, Paris, France
| | - Andreia Neisa
- APDES, Agência Piaget Para O Desenvolvimento, Villa Nova de Gaia, Portugal
| | - Mariana Homen
- APDES, Agência Piaget Para O Desenvolvimento, Villa Nova de Gaia, Portugal
| | - Vânia Mendes
- APDES, Agência Piaget Para O Desenvolvimento, Villa Nova de Gaia, Portugal
| | - Heino Stöver
- Institute for Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany
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Grella CE, Ostlie E, Scott CK, Dennis ML, Carnevale J, Watson DP. A scoping review of factors that influence opioid overdose prevention for justice-involved populations. Subst Abuse Treat Prev Policy 2021; 16:19. [PMID: 33618744 PMCID: PMC7898779 DOI: 10.1186/s13011-021-00346-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is a high risk of death from opioid overdose following release from prison. Efforts to develop and implement overdose prevention programs for justice-involved populations have increased in recent years. An understanding of the gaps in knowledge on prevention interventions is needed to accelerate development, implementation, and dissemination of effective strategies. METHODS A systematic search process identified 43 published papers addressing opioid overdose prevention in criminal justice settings or among justice-involved populations from 2010 to February 2020. Cross-cutting themes were identified, coded and qualitatively analyzed. RESULTS Papers were coded into five categories: acceptability (n = 8), accessibility (n = 4), effectiveness (n = 5), feasibility (n = 7), and participant overdose risk (n = 19). Common themes were: (1) Acceptability of naloxone is associated with injection drug use, overdose history, and perceived risk within the situational context; (2) Accessibility of naloxone is a function of the interface between corrections and community; (3) Evaluations of overdose prevention interventions are few, but generally show increases in knowledge or reductions in opioid overdose; (4) Coordinated efforts are needed to implement prevention interventions, address logistical challenges, and develop linkages between corrections and community providers; (5) Overdose is highest immediately following release from prison or jail, often preceded by service-system interactions, and associated with drug-use severity, injection use, and mental health disorders, as well as risks in the post-release environment. CONCLUSION Study findings can inform the development of overdose prevention interventions that target justice-involved individuals and policies to support their implementation across criminal justice and community-based service systems.
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Affiliation(s)
| | - Erika Ostlie
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
| | - Christy K. Scott
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
| | | | - John Carnevale
- Carnevale Associates LLC, 4 Belinder Rd, Gaithersburg, MD 20878 USA
| | - Dennis P. Watson
- Chestnut Health Systems, 221 W. Walton St, Chicago, IL 60610 USA
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McKendy L, Biro SM, Miron M, Keown LA. Understanding overdose incidents in Canadian federal custody. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 92:103131. [PMID: 33558166 DOI: 10.1016/j.drugpo.2021.103131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND While the community effects of the opioid-related drug crisis in Canada are well documented, limited detailed data is available on overdose trends among custodial populations. Given that this crisis has disproportionate impacts on justice involved persons, research is needed to understand the implications of this crisis within institutional settings. METHODS We examined all overdose incidents that occurred between the 2012/2013 and 2018/2019 fiscal years in a federal correctional institution in Canada. An incident report search was conducted to identify overdose related incidents during this period. Information about the incident and characteristics of the victim was collected from incident reports, investigations, and victim case files. RESULTS Over the period under examination, overdose incidents steadily increased (i.e., from 40 in 2012/2013, to 110 non-fatal incidents in 2018/2019), although there was considerable regional and institutional variation. The number of incidents involving opioids, particularly fentanyl, increased both in raw numbers and as a percentage of overall incidents (i.e., from 3% in 2012/2013 to 47% in 2017/2018, and 34% of non-fatal incidents in 2018/2019). Other substances continue to contribute to overdose incidents; in fact, non-opioid prescription medications (i.e., non-illicit medications such as anti-convulsant drugs and anti-depressants) remain the most common among intentional non-fatal incidents. Relative to the general in-custody population, victims of overdose incidents tended to be younger and were more likely to be serving a determinate sentence, be on a repeat federal sentence, and be serving time for robbery. Mental health conditions and histories of substance use were common. CONCLUSION The effects of the overdose crisis are pronounced within certain Canadian federal institutions, illustrated by a growing number of fentanyl-related incidents. Institutional variation and variation in incidents (e.g., substance and intentionality) highlight diversity in drug activities among this custodial population and the need for multi-faceted responses that are reflective of local situations.
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Affiliation(s)
- Laura McKendy
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada.
| | - Stephanie M Biro
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada
| | - Magda Miron
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada
| | - Leslie Anne Keown
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada
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Moradmand-Badie B, Tran L, Oikarainen N, Degenhardt L, Nielsen S, Roberts J, Ward S, Bowman J, Larney S. Feasibility and acceptability of take-home naloxone for people released from prison in New South Wales, Australia. Drug Alcohol Rev 2020; 40:98-108. [PMID: 32808357 DOI: 10.1111/dar.13144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/03/2020] [Accepted: 07/13/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND AIMS To assess the feasibility and acceptability of a take-home naloxone program for people with a history of opioid use released from prison in New South Wales, Australia. DESIGN AND METHODS Cross-sectional interviews with people with a history of opioid use who were recently released from prison (n = 105), and semi-structured interviews with key clinical and operational staff of Justice Health and Forensic Mental Health Network and Corrective Services NSW (n = 9). RESULTS Among people with a history of opioid use who had recently left prison, there was very high awareness of the elevated risk of overdose following release from prison (95%) and the potential for naloxone to reverse an opioid overdose (97%). Participants considered that their personal risk of overdose was low, despite ongoing opioid use being common. Participants were largely supportive of take-home naloxone, but the majority (83%) stated that proactively obtaining naloxone would be a low priority for them following release. Key informants were supportive of introducing naloxone training and supply and identified barriers to implementation, including adequate resourcing, identifying the population for training, and developing an appropriate model of training and implementation. DISCUSSION AND CONCLUSION There was widespread support for naloxone training in custody and distribution at release among people recently released from prison and key stakeholders in health-care provision and prisons administration. As proactively accessing naloxone is a low priority for patients, naloxone supply at release may be more effective than programs that refer releasees to local pharmacies, but developing a sustainable supply model requires consideration of several barriers.
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Affiliation(s)
| | - Lucy Tran
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Noora Oikarainen
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Suzanne Nielsen
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Jillian Roberts
- Drug and Alcohol Service, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Stephen Ward
- Drug and Alcohol Strategic Operations, Justice Health and Forensic Mental Health Network, Sydney, Australia
| | - Julia Bowman
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, Australia.,School of Public Health, University of Technology Sydney, Sydney, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal and Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, Canada
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Wenger LD, Showalter D, Lambdin B, Leiva D, Wheeler E, Davidson PJ, Coffin PO, Binswanger IA, Kral AH. Overdose Education and Naloxone Distribution in the San Francisco County Jail. JOURNAL OF CORRECTIONAL HEALTH CARE 2019; 25:394-404. [DOI: 10.1177/1078345819882771] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - David Showalter
- Sociology Department, University of California, Berkeley, CA, USA
| | | | - David Leiva
- San Francisco Department of Public Health, Jail Health Services, CA, USA
| | | | | | - Phillip O. Coffin
- Population Health Division, San Francisco Department of Public Health, Community Health Equity & Promotion Branch, San Francisco, CA, USA
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12
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Olsen A, Dwyer R, Lenton S. Take-home naloxone in Australia and beyond. Drug Alcohol Rev 2018; 37:437-439. [PMID: 29744978 DOI: 10.1111/dar.12700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/20/2018] [Accepted: 03/22/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Anna Olsen
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Robyn Dwyer
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.,Faculty of Health Sciences, National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Simon Lenton
- National Drug Research Institute, Curtin University, Perth, Australia
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Petterson AG, Madah-Amiri D. Overdose prevention training with naloxone distribution in a prison in Oslo, Norway: a preliminary study. Harm Reduct J 2017; 14:74. [PMID: 29162122 PMCID: PMC5696738 DOI: 10.1186/s12954-017-0200-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/14/2017] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Prison inmates face a ten times increased risk of experiencing a fatal drug overdose during their first 2 weeks upon release than their non-incarcerated counterparts. Naloxone, the antidote to an opioid overdose, has been shown to be feasible and effective when administered by bystanders. Given the particular risk that newly released inmates face, it is vital to assess their knowledge about opioid overdoses, as well as the impact of brief overdose prevention training conducted inside prisons. METHODS Prison inmates nearing release (within 6 months) in Oslo, Norway, voluntarily underwent a brief naloxone training. Using a questionnaire, inmates were assessed immediately prior to and following a naloxone training. Descriptive statistics were performed for main outcome variables, and the Wilcoxon signed-rank test was used to compare the participants' two questionnaire scores from pre-and post-training. RESULTS Participating inmates (n = 31) were found to have a high baseline knowledge of risk factors, symptoms, and care regarding opioid overdoses. Nonetheless, a brief naloxone training session prior to release significantly improved knowledge scores in all areas assessed (p < 0.001). The training appears to be most beneficial in improving knowledge regarding the naloxone, including its use, effect, administration, and aftercare procedures. CONCLUSIONS Given the high risk of overdosing that prison inmates face upon release, the need for prevention programs is critical. Naloxone training in the prison setting may be an effective means of improving opioid overdose response knowledge for this particularly vulnerable group. Naloxone training provided in the prison setting may improve the ability of inmates to recognize and manage opioid overdoses after their release; however, further studies on a larger scale are needed.
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Affiliation(s)
- Aase Grønlien Petterson
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, P.O. Box 1039 Blindern, 0315 Oslo, Norway
| | - Desiree Madah-Amiri
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, P.O. Box 1039 Blindern, 0315 Oslo, Norway
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