National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia.
Drug and Alcohol Services, South Eastern Sydney Local Health District, Surry Hills, New South Wales, Australia.
Pain Med. 2018 Mar 1;19(3):533-540. doi: 10.1093/pm/pnx021.
Take-home naloxone (THN) is recommended in response to pharmaceutical opioid-related mortality. Some health professionals are reluctant to discuss THN for fear of causing offense. The aims of this study were to assess knowledge of opioid overdose and attitudes toward THN for opioid overdose reversal in people with chronic noncancer pain (CNCP).
Prospective cohort study.
Australia, September to October 2015.
A subset of participants (N = 208) from a cohort of people prescribed restricted opioids for CNCP.
Questions added in the two-year telephone interviews examined knowledge of overdose symptoms and attitudes toward community supply of naloxone. Associations with overdose risk factors and naloxone supply eligibility criteria with attitudes toward naloxone were explored.
Fourteen percent reported ever experiencing opioid overdose symptoms. Participants correctly identified fewer than half of the overdose signs and symptoms. After receiving information on naloxone, most participants (60%), thought it was a "good" or "very good" idea. Few participants reported that they would be "a little" (N = 21, 10%) or "very" offended (N = 7, 3%) if their opioid prescriber offered them naloxone. Positive attitudes toward THN were associated with male gender (odds ratio [OR] = 1.96, 95% confidence interval [CI] = 1.09-3.50), past year cannabis use (OR = 2.52, 95% CI = 1.03-6.16), and past year nicotine use (OR = 2.11, 95% CI = 1.14-3.91).
Most participants had positive attitudes toward THN but low knowledge about opioid overdose symptoms. Strategies for educating patients and their caregivers on opioid toxicity are needed. THN may be best targeted toward those with risk factors in terms of overdose prevention and acceptability.
为应对与药物阿片类相关的死亡，建议使用可带回家的纳洛酮（THN）。一些卫生专业人员因为担心冒犯他人而不愿意讨论 THN。本研究的目的是评估慢性非癌症疼痛（CNCP）患者对阿片类药物过量和对 THN 逆转阿片类药物过量的态度的认识。
前瞻性队列研究。
澳大利亚，2015 年 9 月至 10 月。
从服用限制类阿片类药物治疗 CNCP 的队列中抽取的一组参与者（N=208）。
在两年一次的电话访谈中增加的问题，调查了对过量症状的了解和对社区供应纳洛酮的态度。探讨了与过量风险因素和纳洛酮供应资格标准与对纳洛酮的态度之间的关系。
14%的人报告曾经历过阿片类药物过量症状。参与者正确识别出的过量症状不足一半。在接受纳洛酮信息后，大多数参与者（60%）认为这是一个“好”或“非常好”的主意。少数参与者表示，如果他们的阿片类药物处方医生向他们提供纳洛酮，他们会“有点”（N=21，10%）或“非常”（N=7，3%）感到冒犯。对 THN 的积极态度与男性性别（优势比[OR] = 1.96，95%置信区间[CI] = 1.09-3.50）、过去一年大麻使用（OR = 2.52，95%CI = 1.03-6.16）和过去一年尼古丁使用（OR = 2.11，95%CI = 1.14-3.91）有关。
大多数参与者对 THN 持有积极的态度，但对阿片类药物过量症状的了解程度较低。需要制定教育患者及其护理人员关于阿片类药物毒性的策略。从预防和可接受性的角度来看，THN 可能最好针对那些有过量风险的人。
