Horton Meredith, McDonald Rebecca, Green Traci C, Nielsen Suzanne, Strang John, Degenhardt Louisa, Larney Sarah
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
National Addiction Centre, King's College London, London, UK.
Int J Drug Policy. 2017 Aug;46:7-16. doi: 10.1016/j.drugpo.2017.05.015. Epub 2017 May 30.
People released from correctional settings are at an elevated risk of opioid overdose death in the weeks immediately following release. However, it is not well understood how this population, as a particularly high-risk group, is included in, and benefits from take-home naloxone (THN) programs. The objective of this review is to map research into THN for people released from correctional settings in order to identify further research needs.
We searched electronic databases, grey literature, and conference abstracts for reports on THN for people in or released from correctional settings. Studies were categorised into themes defined by the study's aims and focus. Results from each study were summarised by theme.
We identified 19 studies reporting on THN programs for people released from correctional settings. Studies have examined attitudes towards naloxone among people in custody or recently released from custody (theme 1), and among non-prisoner stakeholders such as prison staff (theme 2). Evaluations and interventional studies (theme 3) have examined process indicators and approaches to naloxone training, including for contacts of prisoners, but there are challenges in assessing health outcomes of THN in the correctional context. Case reports suggest that training in correctional settings translates to action post-release (theme 4).
The feasibility of THN in the context of release from a correctional setting has been established, but there is a need for rigorous research into health outcomes and program implementation. This is an emerging field of study and ongoing assessment of the state of the literature and research needs is recommended.
刚从教养机构获释的人员在获释后的几周内面临阿片类药物过量死亡的风险更高。然而,对于这一特别高危群体如何被纳入居家使用纳洛酮(THN)项目并从中受益,目前尚不清楚。本综述的目的是梳理针对从教养机构获释人员的THN研究,以确定进一步的研究需求。
我们在电子数据库、灰色文献和会议摘要中搜索关于教养机构内或已从教养机构获释人员的THN报告。研究根据其目的和重点分为不同主题。每个研究的结果按主题进行总结。
我们确定了19项关于教养机构获释人员THN项目的研究。这些研究考察了在押人员或刚获释人员(主题1)以及监狱工作人员等非囚犯利益相关者(主题2)对纳洛酮的态度。评估和干预研究(主题3)考察了纳洛酮培训的过程指标和方法,包括针对囚犯接触者的培训,但在教养环境中评估THN的健康结果存在挑战。病例报告表明,教养机构内的培训转化为了释放后的行动(主题4)。
已证实THN在教养机构释放背景下的可行性,但需要对健康结果和项目实施进行严格研究。这是一个新兴的研究领域,建议对文献现状和研究需求进行持续评估。