Ambulance-Attended Opioid Overdoses: An Examination into Overdose Locations and the Role of a Safe Injection Facility

Madah-Amiri, Desiree; Skulberg, A; Braarud, Anne-Cathrine; Dale, Ola; Heyerdahl, Fridtjof; Lobmaier, Philipp; Clausen, Thomas

doi:10.1080/08897077.2018.1485130

Cited by 17 publications

(8 citation statements)

References 37 publications

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“…Being left at the scene of the overdose has been debated over the years and found to be relatively safe, as death immediately after is rare (31,32). This may change in the future with the arrival of more potent opioids, and vary between the location and other circumstances of the overdose (33). There is conflicting evidence regarding the fentanyl-like opioids and the need for potent naloxone formulations (34,35), but basic first aid with ventilation and antidote titration will remain treatment gold standard.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of a novel, approved, 1.4‐mg intranasal naloxone formulation for reversal of opioid overdose—a randomized controlled trial

et al. 2019

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The formulation described has been approved by 12 European countries from 16 th June 2018 under the name of Ventizolve (Respinal in Sweden), produced by Sanivo Pharma AS. Sponsor of this trial was AS Den Norske Eterfabrikk. Ola Dale (OD) was engaged by AS Den Norske Eterfabrikk as Principle Investigator in this study for which OD receives no personal honorarium. OD´s employer Norwegian University of Science and Technology (NTNU) and its subsidiary Technical Transfer Office have signed Pharmacokinetics of a novel, approved, 1.4 mg intranasal naloxone formulation for reversal of opioid overdose-a randomised controlled trial. Preprint for Open Access 4

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of a novel, approved, 1.4‐mg intranasal naloxone formulation for reversal of opioid overdose—a randomized controlled trial

et al. 2019

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“…The SIS model has also been found to be cost-effective and to contribute to reducing pressure on community services, such as emergency medical services (EMS). 4,6 The establishment and operation of community-based SIS in Canada,…”

Section: Introductionmentioning

confidence: 99%

At-a-glance - Supervised Injection Services: a community-based response to the opioid crisis in the City of Ottawa, Canada

DelVillano

Groh

Morrison

et al. 2019

Health Promot Chronic Dis Prev Can

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In response to the current opioid crisis in Canada, establishing safe injection services (SIS) in high risk communities has become more prevalent. In November 2017, The Trailer opened in Ottawa, Canada and tracks client use, overdose treatment and overdoses reversed. We analyzed data collected between November 2017 and August 2018. During peak hours, demand for services consistently exceeded The Trailer’s capacity. Overdoses treated and reversed in this facility increased substantially during this period. Results suggest The Trailer provided an important though not optimal (due to space restrictions) harm reduction service to this high-risk community.

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“…The facility is also a well-organized work environment and allows the EMS to start lower in their titration of dosages and give this dose time to work. Patients treated in the safe injection facility were also more likely to be left at the premises, probably due to the facility offering post-overdose monitoring and counseling [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Prehospital naloxone administration – what influences choice of dose and route of administration?

et al. 2020

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Background Amidst the ongoing opioid crisis there are debates regarding the optimal route of administration and dosages of naloxone. This applies both for lay people administration and emergency medical services, and in the development of new naloxone products. We examined the characteristics of naloxone administration, including predictors of dosages and multiple doses during patient treatment by emergency medical service staff in order to enlighten this debate. Methods This was a prospective observational study of patients administered naloxone by the Oslo City Center emergency medical service, Norway (2014–2018). Cases were linked to The National Cause of Death Registry. We investigated the route of administration and dosage of naloxone, clinical and demographic variables relating to initial naloxone dose and use of multiple naloxone doses and one-week mortality. Results Overall, 2215 cases were included, and the majority (91.9%) were administered intramuscular naloxone. Initial doses were 0.4 or 0.8 mg, and 15% of patients received multiple dosages. Unconscious patients or those in respiratory arrest were more likely to be treated with 0.8 mg naloxone and to receive multiple doses. The one-week mortality from drug-related deaths was 4.1 per 1000 episodes, with no deaths due to rebound opioid toxicity. Conclusions Intramuscular naloxone doses of 0.4 and 0.8 mg were effective and safe in the treatment of opioid overdose in the prehospital setting. Emergency medical staff appear to titrate naloxone based on clinical presentation.

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Ambulance-Attended Opioid Overdoses: An Examination into Overdose Locations and the Role of a Safe Injection Facility

Abstract: Our findings suggest that the opening hours at the safe injection facility and the overdose location may impact the likelihood of ambulance transport for further treatment.

Cited by 17 publications

References 37 publications

Pharmacokinetics of a novel, approved, 1.4‐mg intranasal naloxone formulation for reversal of opioid overdose—a randomized controlled trial

Pharmacokinetics of a novel, approved, 1.4‐mg intranasal naloxone formulation for reversal of opioid overdose—a randomized controlled trial

At-a-glance - Supervised Injection Services: a community-based response to the opioid crisis in the City of Ottawa, Canada

Prehospital naloxone administration – what influences choice of dose and route of administration?

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