From evidence to policy: The Scottish national naloxone programme

McAuley, Andrew; Best, David; Taylor, Avril; Hunter, Carole; Robertson, Roy

doi:10.3109/09687637.2012.682232

Cited by 43 publications

(42 citation statements)

References 27 publications

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“…People who use drugs were successfully trained in the BCTHN program, which is consistent with most other evaluations of THN programs in the literature. 14,16,18,19 Clients reported feeling empowered and were more confident in responding to overdose events, which has been reported in other studies. 10,16,[19][20][21][22][23] Although not measured quantitatively, participants perceived that providing naloxone did not increase drug use or risk-taking behaviour, as has been observed by others.…”

Section: Discussionsupporting

confidence: 66%

“…The questions explored perceptions about the program training, resource materials and implementation; they also probed for concerns identified in the literature, such as the ability of people who use opioids to manage overdose situations and to seek medical follow-up after naloxone administration (i.e., to call 911), and the potential for the THN program to increase risk-taking behaviours, stigma and community awareness. 14 The interview guides were relatively similar across stakeholder groups. Any differences lay in the depth and specificity of some of the questions that were most relevant to that stakeholder.…”

Section: Methodsmentioning

confidence: 96%

See 1 more Smart Citation

A quantitative and qualitative evaluation of the British Columbia Take Home Naloxone program

Banjo¹,

Tzemis

Al-Qutub

et al. 2014

CMAJ Open

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Section: Discussionsupporting

confidence: 66%

Section: Methodsmentioning

confidence: 96%

A quantitative and qualitative evaluation of the British Columbia Take Home Naloxone program

Banjo¹,

Tzemis

Al-Qutub

et al. 2014

CMAJ Open

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“…6 Program evaluations suggest that community-based overdose education and naloxone distribution is an effective strategy to prevent overdose fatalities. [7][8][9][10][11][12] Community-based programs have traditionally served people who use heroin and nonmedical opioids, but a significant proportion of overdose deaths are related to opioids prescribed for pain. [13][14][15][16][17] In the Veteran's Administration and large managed care organizations, the overdose risk is particularly high in people prescribed more than 100 milligrams morphine equivalent daily doses.…”

Section: Introductionmentioning

confidence: 99%

Overdose Education and Naloxone for Patients Prescribed Opioids in Primary Care: A Qualitative Study of Primary Care Staff

et al. 2015

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BACKGROUND:The rate of fatal unintentional pharmaceutical opioid poisonings has increased substantially since the late 1990s. Naloxone is an effective opioid antidote that can be prescribed to patients for bystander use in the event of an overdose. Primary care clinics represent settings in which large populations of patients prescribed opioids could be reached for overdose education and naloxone prescription. OBJECTIVE: Our aim was to investigate the knowledge, attitudes and beliefs about overdose education and naloxone prescription among clinical staff in primary care. DESIGN: This was a qualitative study using focus groups to elucidate both clinic-level and provider-level barriers and facilitators. SETTING: Ten primary care internal medicine, family medicine and infectious disease/HIV practices in three large Colorado health systems. METHODS: A focus group guide was developed based on behavioral theory. Focus group transcripts were coded for manifest and latent meaning, and analyzed for themes using a recursive approach that included inductive and deductive analysis. RESULTS: Themes emerged in four content areas related to overdose education and naloxone prescription: knowledge, barriers, benefits and facilitators. Clinical staff (N= 56) demonstrated substantial knowledge gaps about naloxone and its use in outpatient settings. They expressed uncertainty about who to prescribe naloxone to, and identified a range of logistical barriers to its use in practice. Staff also described fears about offending patients and concerns about increased risk behaviors in patients prescribed naloxone. When considering naloxone, some providers reflected critically and with discomfort on their own opioid prescribing. These barriers were balanced by beliefs that prescribing naloxone could prevent death and result in safer opioid use behaviors. LIMITATIONS: Findings from these qualitative focus groups may not be generalizable to other settings. CONCLUSION: In addition to evidence gaps, logistical and attitudinal barriers will need to be addressed to enhance uptake of overdose education and naloxone prescription for patients prescribed opioids for pain.

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“…(45, 46) The World Health Organization recommended overdose response education for people with opioid use disorders releasing from prison and their family/community supporters. (42) These interventions were not implemented in the prison system at the time of this study, so we are unable to ascertain their effect on mortality risk.…”

Section: Discussionmentioning

confidence: 99%

Clinical risk factors for death after release from prison in Washington State: a nested case–control study

et al. 2015

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Background and aims While mortality rates after prison release are high, little is known about clinical risk factors for death. We sought to identify risk and protective factors for all-cause and accidental poisoning (overdose) death. Design Nested case control study of people released from prison. Setting Washington State Department of Corrections, Washington, USA. Participants Cases (699 all-cause deaths, of which 88 were among women, and 206 additional overdose deaths, of which 76 were among women) between 1999 and 2009 matched 1:1 to controls on sex, age and year of release using risk set sampling. Measurements Prison medical charts were abstracted for clinical information. Independent associations between clinical characteristics and all-cause and overdose mortality were assessed using conditional logistic regression. Findings Key independent risk factors for all-cause mortality included homelessness (Odds Ratio [OR] 1.53, 95% Confidence Interval [CI] 1.06, 2.23), injection drug use (OR 1.54, 95% CI 1.15, 2.05), tobacco use (OR 1.50, 95% CI 1.06, 2.12), cirrhosis (OR 4.42, 95% CI 1.63, 11.98), and psychiatric medications before release (OR 2.37, 95% CI 1.71, 3.29). Independent risk factors for overdose mortality included substance dependence (OR 2.33, 95% CI 1.32, 4.11), injection drug use (OR 2.43, 95% CI 1.53, 3.86), panic disorder (OR 3.87, 95% CI 1.62, 9.21), psychiatric prescriptions before release (OR 2.44, 95% CI 1.55, 3.85), and problems with opiates/sedatives (OR 2.81, 95% CI 1.40, 5.63). Substance use disorder treatment during the index incarceration was protective for all-cause (OR 0.67, 95% CI 0.49, 0.91) and overdose (OR 0.57, 95% CI 0.35, 0.90) mortality. Conclusions Injection drug use and substance use disorders are risk factors for death after release from prison. In-prison substance use treatment services may reduce the risk.

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From evidence to policy: The Scottish national naloxone programme

Cited by 43 publications

References 27 publications

A quantitative and qualitative evaluation of the British Columbia Take Home Naloxone program

A quantitative and qualitative evaluation of the British Columbia Take Home Naloxone program

Overdose Education and Naloxone for Patients Prescribed Opioids in Primary Care: A Qualitative Study of Primary Care Staff

Clinical risk factors for death after release from prison in Washington State: a nested case–control study

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