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阿片类物质使用障碍治疗机构中纳洛酮使用的创新模式:一项前瞻性队列研究。

An Innovative Model for Naloxone Use Within an OTP Setting: A Prospective Cohort Study.

机构信息

Department of Neurosurgery, School of Medicine, University of New Mexico, 1 University of New Mexico, Albuquerque, NM (JGK); Department of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM (MYT); Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM (SRB); Department of Neurosurgery, School of Medicine, University of New Mexico, Albuquerque, NM (MMB); Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM (NG); and Department of Neurosurgery, School of Medicine, University of New Mexico, Albuquerque, NM (HY).

出版信息

J Addict Med. 2018 Mar/Apr;12(2):113-118. doi: 10.1097/ADM.0000000000000374.

Abstract

OBJECTIVES

Unintentional opioid overdose deaths are a public health crisis, and naloxone is the most effective harm reduction tool to curb many of these deaths. There is growing evidence that take-home naloxone can prevent opioid overdose in targeted populations. The goal of this study is to measure the opioid overdose reversal rate with take-home naloxone among participants with a diagnosis of opioid use disorder (OUD) in an opioid treatment program (OTP) setting.

METHODS

Patients enrolled in an outpatient OTP program were eligible for this prospective cohort study between April 4, 2016 and July 4, 2016. Two hundred forty-four study participants received overdose education, instruction on how to use naloxone, and were provided with 2 doses of a take-home naloxone auto-injector kit. They were subsequently followed for 3 months.

RESULTS

Thirty-one study participants reported overdose reversals using naloxone auto-injector kits on 38 community members. All overdose reversals were heroin-related. Eighty-seven per cent of the community members reversed with naloxone were friends or relatives of the study participants.

CONCLUSIONS

This study validates that naloxone is not commonly used on the index study participant, but is often used on a secondary target among people who inject drugs. The large number of overdose reversals reported in this prospective study suggests that this novel model for naloxone use may be replicated at other OTP settings to reduce opioid overdose deaths.

摘要

目的

非故意阿片类药物过量死亡是一个公共卫生危机,纳洛酮是最有效的减少伤害的工具,可以遏制许多此类死亡。越来越多的证据表明,在家用纳洛酮可以预防目标人群中的阿片类药物过量。本研究的目的是测量在阿片类药物治疗计划(OTP)环境中,有阿片类药物使用障碍(OUD)诊断的参与者使用家用纳洛酮逆转阿片类药物过量的比率。

方法

参加门诊 OTP 计划的患者有资格参加这项前瞻性队列研究,时间为 2016 年 4 月 4 日至 2016 年 7 月 4 日。244 名研究参与者接受了过量用药教育、纳洛酮使用说明,并获得了 2 剂家用纳洛酮自动注射器套件。随后对他们进行了 3 个月的随访。

结果

31 名研究参与者报告在 38 名社区成员身上使用纳洛酮自动注射器套件逆转了 38 例过量用药。所有的过量用药逆转都与海洛因有关。在接受纳洛酮逆转的社区成员中,87%是研究参与者的朋友或亲属。

结论

这项研究证实,纳洛酮在本研究参与者中不常用,但在注射毒品者的二级目标人群中经常使用。这项前瞻性研究报告的大量过量用药逆转表明,这种新的纳洛酮使用模式可以在其他 OTP 环境中复制,以减少阿片类药物过量死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada7/5865489/62334f309d44/adm-12-113-g001.jpg

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