Accessing Take-Home Naloxone in British Columbia and the role of community pharmacies: Results from the analysis of administrative data

Moustaqim‐Barrette, Amina; Papamihali, Kristi; Mamdani, Zahra; Williams, Sierra; Buxton, Jane A.

doi:10.1371/journal.pone.0238618

Cited by 18 publications

(19 citation statements)

References 15 publications

(19 reference statements)

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“…Reports on refills in relation to participants is not a commonly presented measure, however Enteen et al (41) found that 24% returned for refill, which is similar to our result. Proportion of naloxone having been used for overdose reversal, in relation to all cause refills, varied between 39-69% (41)(42)(43)(44)(45).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of and Experience Among People Who Use Take-Home Naloxone in Skåne County, Sweden

Troberg

Isendahl

Blomé

et al. 2022

Front. Public Health

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BackgroundOpioid overdose related injury or death can be prevented by bystander naloxone administration. For naloxone to be present when and where overdoses occur, opioid prevention education and naloxone distribution (OPEND) must be established on a broad level. This is the 30-month follow-up of the first multi-site naloxone project in Sweden, implemented at 31 sites in the County of Skåne 2018.AimTo address participant characteristics and factors associated with returning for naloxone refill and with having used naloxone for overdose reversal. An additional aim was to describe self-reported reasons for naloxone refill and overdose experiences.MethodsData were collected during June 2018—December 2020 through questionnaires at baseline and upon naloxone refill of the initial and subsequent naloxone kit. Descriptive statistics was used to address participant characteristics, those returning for naloxone refill and reporting overdose reversal. Chi-2 test was used for variable comparison between groups. Factors associated with overdose reversals were examined by logistic regression analysis. Reasons for naloxone refill, overdose situation and management were presented descriptively.ResultsAmong 1,079 study participants, 22% (n = 235) returned for naloxone refill, of which 60% (n = 140) reported a total of 229 overdose reversals. Reversals were more likely to be reported by participants trained at needle exchange programs (NEPs) [adjusted odds ratio (AOR) = 5.18, 95% Confidence interval (CI) = 3.38–7.95)], with previous experience of own (AOR = 1.63, 95% CI = 1.03–2.58) or witnessed (AOR = 2.12, 95% CI = 1.05–4.29) overdose, or who had used sedatives during the last 30 days before initial training (AOR = 1.56, 95% CI = 1.04–2.33). A majority of overdoses reportedly occurred in private settings (62%), where the victim was a friend (35%) or acquaintance (31%) of the rescuer.ConclusionParticipants with own risk factors associated with overdose (e.g., injection use, concomitant use of benzodiazepines and previous experience of own overdose) were more likely to report administering naloxone for overdose reversal. Overdose management knowledge was high. The findings indicate that implementation of multi-site OPEND reaches individuals at particularly high risk of own overdose in settings with limited previous harm reduction strategies and favors a further scaling up of naloxone programs in similar settings.

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Section: Discussionmentioning

confidence: 99%

Characteristics of and Experience Among People Who Use Take-Home Naloxone in Skåne County, Sweden

Troberg

Isendahl

Blomé

et al. 2022

Front. Public Health

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“…The province has also experienced a decline in visits to OPS/SCS during the COVID-19 pandemic, which further increases risks of adverse outcomes from overdose [ 30 ]. Take Home Naloxone kits are widely available to community members throughout BC [ 12 , 13 ], but the FORB program improves access to naloxone in BC by providing a dedicated supply of naloxone and protective equipment including CPR face shields, gloves, and staff training supplies for use by non-healthcare service providers in the workplace where there is a risk of overdoses on site [ 14 , 15 ].This further eliminates challenges that may be encountered by community agencies that may have not have allocated budgets or capacities to source these supplies. Having these resources readily available helps non-healthcare service providers in being prepared and supported to respond to overdoses.…”

Section: Discussionmentioning

confidence: 99%

“…The BC THN program, which launched in 2012, was rapidly expanded in response to increasing overdose fatalities in 2016 [10][11][12][13]. Although the BC THN program was widely available across BC, the THN kits and supplies are not intended for occupational purposes.…”

Section: Introductionmentioning

confidence: 99%

The implementation and role of a staff naloxone program for non-profit community-based sites in British Columbia: A descriptive study

et al. 2021

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Introduction The BC Centre for Disease Control implemented the Facility Overdose Response Box (FORB) program December 1st, 2016 to train and support non-healthcare service providers who may respond to an overdose in the workplace. The program aims to support staff at non-profit community-based organizations by ensuring policy development, training, practice overdose response exercises, and post-overdose debriefing opportunities are established and implemented. Materials and methods Three data sources were used in this descriptive cross-sectional study: FORB site registration data; naloxone administration forms; and a survey that was distributed to FORB sites in February 2019. FORB program site and naloxone administration data from December 1st, 2016 to December 31st, 2019 were analyzed using descriptive statistics. A Cochran-Armitage test was used to assess trends over time in naloxone administration event characteristics. Site coordinator survey results are reported to supplement findings from administrative data. Results As of December 31st, 2019, FORB was implemented at 613 sites across BC and 1,758 naloxone administration events were reported. The majority (86.3%, n = 1,517) were indicated as overdose reversals. At registration, 43.6% of sites provided housing services, 26.3% offered harm reduction supplies, and 18.6% provided Take Home Naloxone. Refusal to be transported to hospital following overdose events when emergency services were called showed an increasing trend over time. Most respondents (81.3%) reported feeling confident in their ability to respond to the overdose and 59.6% were offered staff debrief. Based on the 89 site survey responses, supports most commonly made available following an overdose were debrief with a fellow staff member (91.0%), debrief with a supervisor (89.9%), and/or counselling services (84.3%). Conclusions The uptake of the FORB program has contributed to hundreds of overdose reversals in community settings in BC. Findings suggest that the FORB program supports developing staff preparedness and confidence in overdose response in community-based settings.

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“…In December 2017, the BC THN program was rolled out in community pharmacies, also at no charge, greatly increasing access to kits, especially in remote regions [ 20 ]. Prior research indicates that people who are not personally at risk of overdose are more likely to obtain kits from pharmacy sites, especially when collecting a naloxone kit for the first time [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with take-home naloxone kit usage in British Columbia: an analysis of administrative data

Lei

Ferguson

Geiger

et al. 2022

Subst Abuse Treat Prev Policy

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Background The British Columbia (BC) Take-Home Naloxone (THN) program provides naloxone to people at risk of experiencing or witnessing an opioid overdose for use in reversing suspected overdose events. This study seeks to examine trends and correlates of individuals obtaining a THN kit in BC between 2017 and 2020. Methods Records of THN kits distributed between 2017 and 2020 were the primary source of data for this analysis. Frequency tables were used to describe characteristics of people obtaining kits from THN sites. Correlates of individuals obtaining a THN kit to replace a previous kit reported as used to reverse an overdose were assessed with multivariate logistic regression. Results Between January 1, 2017, and December 31, 2020, 240,606 THN kits were reported distributed by registered sites to members of the public, with 90,011 records indicating that a kit was obtained to replace a previous kit that had been used to reverse an overdose. There was a significant trend in increasing kits reported used by year (p < 0.01). The kit recipient’s risk of overdose was a significant predictor of having reported using a THN kit, and the strength of the association was dependent on gender (Male: Adjusted odds ratio (AOR) 5.37 [95% confidence interval (CI) 5.08 – 5.67]; Female: AOR 8.35 [95% CI 7.90 – 8.82]; Trans and gender expansive: AOR 3.68 [95% CI 2.82 – 4.79]). Conclusions Between 2017 and 2020, THN kits were used to reverse tens of thousands of overdose events in BC, with people at risk of overdose (i.e. people who use drugs [PWUD]) having greater odds of using a kit to reverse an overdose than those not at risk. Thus, PWUD are responsible for reversing the vast majority of overdoses. THN kits are being distributed to the people who use them most. However, additional strategies in conjunction with community-based naloxone distribution programs are needed to address the rising number of illicit drug toxicity deaths.

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Accessing Take-Home Naloxone in British Columbia and the role of community pharmacies: Results from the analysis of administrative data

Cited by 18 publications

References 15 publications

Characteristics of and Experience Among People Who Use Take-Home Naloxone in Skåne County, Sweden

Characteristics of and Experience Among People Who Use Take-Home Naloxone in Skåne County, Sweden

The implementation and role of a staff naloxone program for non-profit community-based sites in British Columbia: A descriptive study

Factors associated with take-home naloxone kit usage in British Columbia: an analysis of administrative data

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