Correlates of take-home naloxone kit possession among people who use drugs in British Columbia: A cross-sectional analysis

Moustaqim‐Barrette, Amina; Papamihali, Kristi; Crabtree, Alexis; Graham, Brittany; Karamouzian, Mohammad; Buxton, Jane A.

doi:10.1016/j.drugalcdep.2019.107609

Cited by 29 publications

(24 citation statements)

References 16 publications

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“…Data collection for this study was conducted from May to August 2018 through the 2018 Harm Reduction Client Survey, which was administered at 27 harm reduction supply distribution sites across BC. The methods of site and individual recruitment have been previously described [ 11 , 15 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…Among others, this includes the BC take-home naloxone (THN) program, expanded opioid agonist treatment (OAT) availability, and observed consumption sites, all of which had a significant impact on preventing overdose deaths [ 14 ]. The THN program, for instance, has been responsive to the overdose crisis by getting naloxone kits into the hands of those that need it most [ 15 , 16 ], with more than 53,000 THN kits reported as used to reverse an overdose between 2017 and 2019 [ 17 ]. However, it is important to note that someone else must be present for naloxone to be administered to an individual experiencing an overdose.…”

Section: Introductionmentioning

confidence: 99%

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Convenience and comfort: reasons reported for using drugs alone among clients of harm reduction sites in British Columbia, Canada

et al. 2020

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Background North American communities are severely impacted by the overdose crisis, particularly in British Columbia (BC), which has the highest toxic drug overdose death rate in Canada. Most fatal overdoses in BC occurred among individuals using alone and in private residences. This study aimed to assess prevalence and reasons for using drugs alone among people accessing harm reduction services in BC. Methods We recruited harm reduction supply distribution site clients from 22 communities across BC. Descriptive statistics and multivariable logistic regression were used to describe factors associated with using alone. Thematic analysis of free-text responses providing reasons for using alone were grouped with survey data and additional themes identified. Results Overall, 75.8% (n = 314) of the study sample (N = 414) reported using drugs alone within the last week. Those that reported using alone did not differ from those that did not by gender, age, urbanicity, or preferred drug use method. Among those that used alone, 73.2% (n = 230) used opioids, 76.8% (n = 241) used crystal meth, 41.4% (n = 130) used crack/cocaine, and 44.6% (n = 140) used alcohol in the past week. Polysubstance use involving stimulants, opioids, and/or benzodiazepines was reported by 68.5% (n = 215) of those that used alone. Additionally, 22.9% (n = 72) of those that used alone had experienced an opioid and/or stimulant overdose in the past 6 months. In a multivariable logistic regression model, having no regular housing and past week crack/cocaine use were associated with using alone (adjusted odds ratio (AOR): 2.27; 95% CI 1.20–4.27 and AOR: 2.10; 95% CI 1.15–3.82, respectively). The most common reason reported for using alone was convenience and comfort of using alone (44.3%). Additional reasons included: stigma/hiding drug use (14.0%); having no one around (11.7%); safety (9.6%); and not wanting to share drugs with others (8.6%). Conclusions Using drugs alone, particularly for convenience and comfort, is ubiquitous among people accessing harm reduction services. Overdose prevention measures that go beyond individual behaviour changes, including providing a safer supply of drugs and eliminating stigma, are paramount to mitigate harms. These interventions are especially necessary as emergence of coronavirus disease may further exacerbate unpredictability of illicit drug content and overdose risk.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Convenience and comfort: reasons reported for using drugs alone among clients of harm reduction sites in British Columbia, Canada

et al. 2020

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“…Alternatively, those who do not inject drugs or who may not be able to easily reach the health department, due to a lack of transportation or limited mobility, may only be able to access naloxone from a local pharmacy. PWUO but who do not inject drugs may perceive that they have a low risk of overdose [23] and may therefore place a lower priority on obtaining naloxone, especially if they believe it is difficult to access. Increasing awareness of different channels to access naloxone is an essential step forward in improving coverage and prevention overdose mortality.…”

Section: Discussionmentioning

confidence: 99%

Practical implications of naloxone knowledge among suburban people who use opioids

et al. 2021

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Background Naloxone distribution programs have been a cornerstone of the public health response to the overdose crisis in the USA. Yet people who use opioids (PWUO) continue to face a number of barriers accessing naloxone, including not knowing where it is available. Methods We used data from 173 PWUO from Anne Arundel County, Maryland, which is located between Baltimore City and Washington, DC. We assessed the prevalence of recently (past 6 months) receiving naloxone and currently having naloxone, the type(s) of the naloxone kits received, and the perceived ease/difficultly of accessing naloxone. We also assessed participants knowledge of where naloxone was available in the community. Results One third (35.7%) of participants had recently received naloxone. Most who had received naloxone received two doses (72.1%), nasal naloxone (86.9%), and education about naloxone use (72.1%). Most currently had naloxone in their possession (either on their person or at home; 78.7%). One third (34.4%) believed naloxone was difficult to obtain in their community. Only half (56.7%) knew of multiple locations where they could get naloxone. The health department was the most commonly identified naloxone source (58.0%). Identifying multiple sources of naloxone was associated with being more likely to perceive that naloxone is easy to access. Discussion Our results suggest that additional public health efforts are needed to make PWUO aware of the range of sources of naloxone in their communities in order to ensure easy and continued naloxone access to PWUO.

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“…Several studies which investigated the widespread administration of community naloxone kits and training have identified a significant increase in overdose recovery (21). While Canada has ensured the distribution of Naloxone to emergency workers and hospitals in all 13 provinces and territories, distribution of Naloxone kits to public spaces has not been as widespread (22). As such, it is important for healthcare professionals to continue to develop high quality evidence and engage in advocacy to ensure naloxone kits are readily available.…”

Section: Naloxone Distribution and Overdose First Respondersmentioning

confidence: 99%

Substance Use and Homelessness: An Inner-City Group Discussion on Marginalization in Healthcare Practices

Hanna¹,

Burke²

2019

UOJM

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Ottawa Inner City Health’s Managed Alcohol Program administers alcohol to its patients who are struggling with alcohol dependency. Although it may seem like a paradoxical approach, this program is a harm-reduction strategy intended to help some of the most marginalized peoples in Ottawa. A qualitative discussion group composed of individuals utilizing various substance use support programs in Ottawa comments on various strategies to reduce stigma against inner-city individuals, support illicit drug users, and prevent overdoses. Healthcare professionals are well positioned to ensure these strategies are put to action by advocating for patients with substance use issues and promoting equitable healthcare.

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Correlates of take-home naloxone kit possession among people who use drugs in British Columbia: A cross-sectional analysis

Cited by 29 publications

References 16 publications

Convenience and comfort: reasons reported for using drugs alone among clients of harm reduction sites in British Columbia, Canada

Convenience and comfort: reasons reported for using drugs alone among clients of harm reduction sites in British Columbia, Canada

Practical implications of naloxone knowledge among suburban people who use opioids

Substance Use and Homelessness: An Inner-City Group Discussion on Marginalization in Healthcare Practices

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