Nolan Seonaid, Buxton Jane, Dobrer Sabina, Dong Huiru, Hayashi Kanna, Milloy M J, Kerr Thomas, Montaner Julio, Wood Evan
1 British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, British Columbia, Canada.
2 Department of Medicine, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada.
Public Health Rep. 2017 Sep/Oct;132(5):563-569. doi: 10.1177/0033354917717230. Epub 2017 Jul 27.
Although take-home naloxone (THN) programs are integral in strategies to prevent overdose deaths among opioid users, the uptake of THN among people who use drugs (PWUD) (including non-opioid users) is unknown. The objectives of this study were to determine awareness, possession, and use of THN among PWUD in Vancouver, Canada, and identify barriers to adopting this strategy.
From December 1, 2014, to May 29, 2015, participants in 2 prospective cohort studies of PWUD in Vancouver completed a standardized questionnaire, which asked about awareness, possession, and use of THN; sociodemographic characteristics; and drug use patterns. We conducted multivariable logistic regression analyses to determine factors independently associated with awareness and possession of THN.
Of 1137 PWUD, 727 (64%) reported at least 1 previous overdose ever, and 220 (19%) had witnessed an overdose in the previous 6 months. Although 769 (68%) participants overall reported awareness of THN, only 88 of 392 (22%) opioid users had a THN kit, 18 (20%) of whom had previously administered naloxone. Factors that were positively associated with awareness of THN included witnessing an overdose in the previous 6 months (adjusted odds ratio [aOR] = 2.23; 95% confidence interval [CI], 1.49-3.34; P < .001), possession of THN (aOR = 1.85; 95% CI, 1.11-3.06; P = .02), younger age (aOR = 1.02; 95% CI, 1.01-1.04; P = .003), white race (aOR = 1.67; 95% CI, 1.27-2.19; P < .001), hepatitis C infection (aOR = 1.63; 95% CI, 1.13-2.36; P = .01), residing in Vancouver's Downtown Eastside neighborhood (aOR = 1.93; 95% CI, 1.47-2.53; P < .001), and at least daily heroin injection (aOR = 1.69; 95% CI, 1.09-2.62; P < .02).
Efforts to improve knowledge of and participation in the THN program may contribute to reduced opioid overdose mortality in Vancouver.
尽管带回家的纳洛酮（THN）项目是预防阿片类药物使用者过量死亡策略的重要组成部分，但吸毒者（包括非阿片类药物使用者）对THN的接受情况尚不清楚。本研究的目的是确定加拿大温哥华吸毒者对THN的知晓情况、持有情况和使用情况，并找出采用该策略的障碍。
2014年12月1日至2015年5月29日，温哥华两项吸毒者前瞻性队列研究的参与者完成了一份标准化问卷，该问卷询问了对THN的知晓情况、持有情况和使用情况；社会人口学特征；以及吸毒模式。我们进行了多变量逻辑回归分析，以确定与THN知晓和持有独立相关的因素。
在1137名吸毒者中，727人（64%）报告曾至少有过一次过量用药经历，220人（19%）在过去6个月内目睹过一次过量用药。尽管总体上有769名（68%）参与者报告知晓THN，但在392名阿片类药物使用者中只有88人（22%）有THN试剂盒，其中18人（20%）曾使用过纳洛酮。与THN知晓呈正相关的因素包括在过去6个月内目睹过一次过量用药（调整后的优势比[aOR]=2.23；95%置信区间[CI]，1.49 - 3.34；P<.001）、持有THN（aOR = 1.85；95% CI，1.11 - 3.06；P = .02）、年龄较小（aOR = 1.02；95% CI，1.01 - 1.04；P = .003）、白人种族（aOR = 1.67；95% CI，1.27 - 2.19；P<.001）、丙型肝炎感染（aOR = 1.63；95% CI，1.13 - 2.36；P = .01）、居住在温哥华市中心东区社区（aOR = 1.93；95% CI，1.47 - 2.53；P<.001）以及至少每天注射海洛因（aOR = 1.69；95% CI，1.09 - 2.62；P<.02）。
努力提高对THN项目的认识和参与度可能有助于降低温哥华阿片类药物过量死亡率。
