Evaluation of the Staying Alive programme: Training injection drug users to properly administer naloxone and save lives

Tobin, Karin E.; Sherman, Susan G.; Beilenson, Peter; Welsh, Christopher; Latkin, Carl A.

doi:10.1016/j.drugpo.2008.03.002

Cited by 135 publications

(109 citation statements)

References 12 publications

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“…In the study, this training improved the management of overdose and there were no reports of adverse reactions other than anger associated with withdrawal. This confirms the user acceptability, efficacy and safety results of smaller accounts of naloxone distribution programs in USA [3][4][5][6][7][8][9].…”

supporting

confidence: 63%

[Commentary] CASE FOR PEER NALOXONE FURTHER STRENGTHENED

Lenton

2008

Addiction

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supporting

confidence: 63%

[Commentary] CASE FOR PEER NALOXONE FURTHER STRENGTHENED

Lenton

2008

Addiction

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“…Though THN programs exist in many other jurisdictions, 9,14,15 including other provinces in Canada, 16,18 Alberta's THN program stands out due to its comprehensive, provincial scope and rapid scale-up. Alberta was uniquely poised to deliver a large, provincewide, multi-sectoral and multi-jurisdictional THN program as part of a comprehensive response to increasing opioid and fentanylrelated morbidity and mortality, due to the province-wide nature of AHS and the existing response structures available.…”

Section: Discussionmentioning

confidence: 99%

“…13 Programs have been implemented in Europe, the US and Australia since the mid-1990s. 9,14,15 The first Canadian THN community program was initiated in 2005 by Streetworks in Edmonton, Alberta 16 and there are now programs in the majority of Canada's provinces and territories. 17 The implementation of such programs reduces mortality from opioid poisonings.…”

mentioning

confidence: 99%

Alberta’s provincial take-home naloxone program: A multi-sectoral and multi-jurisdictional response to overdose

Freeman

Bourque²,

Etches

et al. 2017

Can J Public Health

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SETTING: Alberta is a prairie province located in western Canada, with a population of approximately 4.3 million. In 2016, 363 Albertans died from apparent drug overdoses related to fentanyl, an opioid 50-100 times more toxic than morphine. This surpassed the number of deaths from motor vehicle collisions and homicides combined.INTERVENTION: Naloxone is a safe, effective, opioid antagonist that may quickly reverse an opioid overdose. In July 2015, a committee of communitybased harm reduction programs in Alberta implemented a geographically restricted take-home naloxone (THN) program. The successes and limitations of this program demonstrated the need for an expanded, multi-sectoral, multi-jurisdictional response. The provincial health authority, Alberta Health Services (AHS), used previously established incident command system processes to coordinate implementation of a provincial THN program.OUTCOMES: Alberta's provincial THN program was implemented on December 23, 2015. This collaborative program resulted in a coordinated response across jurisdictional levels with wide geographical reach. Between December 2015 and December 2016, 953 locations, including many community pharmacies, registered to dispense THN kits, 9572 kits were distributed, and 472 reversals were reported. The provincial supply of THN kits more than tripled from 3000 to 10 000. IMPLICATIONS:Alberta was uniquely poised to deliver a large, province-wide, multi-sectoral and multi-jurisdictional THN program as part of a comprehensive response to increasing opioid-related morbidity and mortality. The speed at which AHS was able to roll out the program was made possible by work done previously and the willingness of multiple jurisdictions to work together to build on and expand the program.KEY WORDS: Fentanyl; take-home naloxone; harm reduction; opioid overdose La traduction du résumé se trouve à la fin de l'article.

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“…By the 2010s intervention studies typically reported the number of overdoses reversed with naloxone as a central outcome; high naloxone usage rates confirmed the 'trainability' of heroin users to adequately respond to overdose (Green et al, 2008;Lopez-Gaston et al, 2009;Markham-Piper et al, 2008;McAuley et al, 2010;Strang et al, 2008a;Tobin et al, 2009;Wagner et al, 2010). A systematic review of naloxone usage rates found that, for every 100 opioid users trained and supplied with THN, 9% of THN kits are likely used for overdose reversal within the first three months post-training (McAuley et al, 2015).…”

Section: -2016 Circa: Emergence Of Stronger Data Alternative Impmentioning

confidence: 99%

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

McDonald

Campbell

Strang

2017

Drug and Alcohol Dependence

117

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Highlights Deaths from opioid overdose can be prevented by prompt administration of naloxone  It has been 20 years since take-home naloxone provision was first proposed  Take-home naloxone programs have recently overcome legal barriers in many countries  Take-home naloxone provision remains low compared to evident growing clinical need  The 'opt-out' model of required pre-provision may achieve wider naloxone coverage Abstract Background: Opioid overdose is a major cause of mortality, but injury and fatal outcomes can be prevented by timely administration of the opioid antagonist naloxone. Pre-provision of naloxone to opioid users and family members (take-home naloxone, THN) was first proposed in 1996, and WHO Guidelines were issued in 2014. While widespread in some countries, THN is minimally available or absent elsewhere. This review traces the development of THN over twenty years, from speculative harm reduction proposal to public health strategy.Method: Medline and PsycINFO were searched for peer-reviewed literature using Boolean queries: 1) "naloxone OR Narcan"; 2) "(opioid OR opiate) AND overdose AND prevention". Grey literature and specialist websites were also searched. Data were extracted and synthesized as narrative review, with key events presented as chronological timeline. Results Conclusions:Framed as a public health tool for harm reduction, THN has overcome social, clinical, and legal barriers in many jurisdictions. Nonetheless, the rising death toll of opioid overdose illustrates that current THN coverage is insufficient, and greater public investment in overdose prevention will be required if THN is to achieve its full potential impact.

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Evaluation of the Staying Alive programme: Training injection drug users to properly administer naloxone and save lives

Cited by 135 publications

References 12 publications

[Commentary] CASE FOR PEER NALOXONE FURTHER STRENGTHENED

[Commentary] CASE FOR PEER NALOXONE FURTHER STRENGTHENED

Alberta’s provincial take-home naloxone program: A multi-sectoral and multi-jurisdictional response to overdose

Twenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturation

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