Siegler Anne, Huxley-Reicher Zina, Maldjian Lara, Jordan Robyn, Oliver Chloe, Jakubowski Andrea, Kunins Hillary V
New York City Department of Health and Mental Hygiene, 42-09 28th Street, 19th Floor, Long Island City, NY 11101, United States.
Drug Alcohol Depend. 2017 Oct 1;179:124-130. doi: 10.1016/j.drugalcdep.2017.06.029. Epub 2017 Jul 24.
Providing naloxone to laypersons who are likely to witness an opioid overdose is now a widespread public health response to the national opioid overdose epidemic. Estimating the proportion of individuals who use naloxone can define its potential impact to reduce overdose deaths at a population level. We determined the proportion of study participants who used naloxone within 12 months following training and factors associated with witnessing overdose and naloxone use.
We conducted a prospective, observational study of individuals completing overdose prevention training (OPT) between June and September 2013. Participants were recruited from New York City's six largest overdose prevention programs, all operated by syringe exchange programs. Questionnaires were administered at four time points over 12 months. Main outcomes were witnessing or experiencing overdose, and naloxone administration.
Of 675 individuals completing OPT, 429 (64%) were approached and 351 (52%) were enrolled. Overall, 299 (85%) study participants completed at least one follow-up survey; 128 (36%) witnessed at least one overdose. Of 312 witnessed opioid overdoses, naloxone was administered in 241 events (77%); 188 (60%) by the OPT study participant. Eighty-six (25%) study participants administered naloxone at least once. Over one third of study participants (30, 35%) used naloxone 6 or more months after training.
Witnessing an overdose and naloxone use was common among this study cohort of OPT trainees. Training individuals at high risk for witnessing overdoses may reduce opioid overdose mortality at a population level if sufficient numbers of potential responders are equipped with naloxone.
向可能目睹阿片类药物过量使用情况的非专业人员提供纳洛酮，是目前针对全国阿片类药物过量流行情况的一种广泛的公共卫生应对措施。估计使用纳洛酮的个体比例可以确定其在人群层面上减少过量用药死亡的潜在影响。我们确定了研究参与者在培训后12个月内使用纳洛酮的比例以及与目睹过量用药和使用纳洛酮相关的因素。
我们对2013年6月至9月期间完成过量用药预防培训（OPT）的个体进行了一项前瞻性观察研究。参与者从纽约市六个最大的过量用药预防项目中招募，所有项目均由注射器交换项目运营。在12个月内的四个时间点进行问卷调查。主要结果是目睹或经历过量用药以及使用纳洛酮。
在675名完成OPT的个体中，429名（64%）被接触，351名（52%）被纳入研究。总体而言，299名（85%）研究参与者完成了至少一次随访调查；128名（36%）至少目睹过一次过量用药情况。在312次目睹的阿片类药物过量用药事件中，有241次（77%）使用了纳洛酮；其中188次（60%）是由OPT研究参与者使用的。86名（25%）研究参与者至少使用过一次纳洛酮。超过三分之一的研究参与者（30名，35%）在培训6个月或更长时间后使用了纳洛酮。
在这个OPT培训学员的研究队列中，目睹过量用药和使用纳洛酮的情况很常见。如果有足够数量的潜在反应者配备纳洛酮，对有高风险目睹过量用药情况的个体进行培训可能会在人群层面上降低阿片类药物过量用药死亡率。
