Knowledge and possession of take-home naloxone kits among street-involved youth in a Canadian setting: a cohort study

Abstract

BackgroundThe distribution of take-home naloxone (THN) kits has been an important strategy in reducing overdose fatalities among people who use drugs. However, little is known about the use of THN among youth who are street-involved. The present study explores knowledge and possession of THN among street-involved youth in a Canadian setting.MethodsData were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth age 14–28 at enrollment in Vancouver, Canada. Participants completed a standardized questionnaire, which included items related to knowledge and possession of THN, sociodemographic characteristics, and substance use-related factors. Multivariable logistic regression models were used to identify factors independently associated with knowledge and possession of THN.ResultsBetween December 2014 and November 2016, 177 youth were interviewed, including 68 females (38.4%). While 126 (71.2%) participants reported knowledge of THN, only 40 (22.6%) possessed a THN kit. Caucasian/white ethnicity was found to be positively associated with both knowledge and possession of THN (both p < 0.05). Public injection drug use in the last 6 months was found to be positively associated with knowledge of THN, while daily heroin use and daily methamphetamine use were associated with possession of THN (all p < 0.05). Male gender was negatively associated with possession of THN (p < 0.05).ConclusionsThese findings highlight important gaps between knowledge and possession of THN among youth and the need to increase participation in THN programs among specific populations including non-white and male youth. Further research is needed to gain a better understanding of the barriers that may prevent certain youth from acquiring THN kits.

Addressing co-occurring public health emergencies: The importance of naloxone distribution in the era of COVID-19

“…parks, buildings) where outreach is often conducted. These complications underscore the need for continued support in naloxone distribution across communities and amongst first responders, particularly as uptake of THN has been associated with having previously experienced an overdose, drug use injection, and being linked with harm reduction services (Farrugia et al, 2019;Goldman-Hasbun et al, 2017;O'Brien, Dabbs, Dong, Veugelers & Hyshka, 2019).…”

Take-Home Naloxone for the Emergency Interim Management of Opioid Overdose: The Public Health Application of an Emergency Medicine

“…There are also significant barriers in relation to knowledge and skills including the need for education and training of potential healthcare providers to enable adoption of THN in the MHCP model [144, 178]. While PWUO often have considerable knowledge of overdose signs and symptoms, knowledge gaps exist amongst different populations with opioid-overdose risk [155, 173, 179].…”

Averting Opioid-induced Respiratory Depression without Affecting Analgesia

“…So-called take home naloxone programs have been shown to reduce opioid overdose mortality rates, with little risks in naloxone administration by non-medically trained individuals. [124][125][126] Hence, nonopioid respiratory stimulants should be used as drugs that prevent rather than treat opioid-induced respiratory depression. Still, none of the available pharmaceutical agents highlighted in this review are currently adequately scrutinized to allow their therapeutic use in opioidinduced respiratory depression because they either have ample side effects that limit their use (e.g., doxapram) or require further study of efficacy and toxicity.…”