Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
Norwegian Institute of Public Health, Oslo, Norway.
Addiction. 2019 Jan;114(1):92-100. doi: 10.1111/add.14425. Epub 2018 Sep 14.
To examine uptake following a large-scale naloxone programme by estimating distribution rates since programme initiation and the proportion among a sample of high-risk individuals who had attended naloxone training, currently possessed or had used naloxone. We also estimated the likelihood of naloxone possession and use as a function of programme duration, individual descriptive and substance use indicators.
(1) Distribution data (June 2014-August 2017) and date of implementation for each city and (2) a cross-sectional study among a sample of illicit substance users interviewed September 2017.
Seven Norwegian cities.
A total of 497 recruited users of illegal opioids and/or central stimulants.
Primary outcomes: naloxone possession and use. Random-intercepts logistic regression models (covariates: male, age, homelessness/shelter use, overdose, incarceration, opioid maintenance treatment, income sources, substance use indicators, programme duration).
Overall, 4631 naloxone nasal sprays were distributed in the two pilot cities, with a cumulative rate of 495 per 100 000 population. In the same two cities, among high-risk individuals, 44% and 62% reported current naloxone possession. The possession rates of naloxone corresponded well to the duration of each participating city's distribution programme. Overall, in the six distributing cities, 58% reported naloxone training, 43% current possession and 15% naloxone use. The significant indicators for possession were programme duration [adjusted odds ratios (aOR) = 1.44, 95% confidence interval (CI = 0.82-2.37], female gender (aOR = 1.97, 95% CI = 1.20-3.24) and drug-dealing (aOR = 2.36, 95% CI = 1.42-3.93). The significant indicators for naloxone use were programme duration (aOR = 1.49 95%, CI = 1.15-1.92), homelessness/shelter use (aOR = 2.06, 95% CI = 1.02-4.17), opioid maintenance treatment (OMT) (aOR = 2.07, 95% CI = 1.13-3.78), drug-dealing (aOR = 2.40, 95% CI = 1.27-4.54) and heroin injecting (aOR = 2.13, 95% CI = 1.04-4.38).
A large-scale naloxone programme in seven Norwegian cities with a cumulative distribution rate of 495 per 100 000 population indicated good saturation in a sample of high-risk individuals, with programme duration in each city as an important indicator for naloxone possession and use.
通过估计自项目启动以来的分配率以及参加纳洛酮培训的高危人群中目前拥有或使用过纳洛酮的比例，来评估一项大规模纳洛酮项目的接受情况。我们还估计了纳洛酮拥有和使用的可能性，作为项目持续时间、个体描述和药物使用指标的函数。
（1）分配数据（2014 年 6 月至 2017 年 8 月）和每个城市的实施日期，以及（2）2017 年 9 月对非法药物使用者进行的横断面研究。
挪威七个城市。
共有 497 名非法阿片类药物和/或中枢兴奋剂使用者。
纳洛酮拥有和使用。随机截距逻辑回归模型（协变量：男性、年龄、无家可归/收容所使用、过量、监禁、阿片类药物维持治疗、收入来源、药物使用指标、项目持续时间）。
总体而言，在两个试点城市共分发了 4631 支纳洛酮鼻喷雾剂，累积率为每 10 万人 495 支。在这两个城市，44%和 62%的高危人群报告目前拥有纳洛酮。纳洛酮的拥有率与每个参与城市的分配项目持续时间相符。总体而言，在六个分配城市中，58%报告接受了纳洛酮培训，43%目前拥有纳洛酮，15%使用了纳洛酮。拥有纳洛酮的显著指标是项目持续时间[调整后的优势比（aOR）=1.44，95%置信区间（CI）=0.82-2.37]，女性（aOR=1.97，95%CI=1.20-3.24）和贩毒（aOR=2.36，95%CI=1.42-3.93）。纳洛酮使用的显著指标是项目持续时间（aOR=1.49，95%CI=1.15-1.92）、无家可归/收容所使用（aOR=2.06，95%CI=1.02-4.17）、阿片类药物维持治疗（OMT）（aOR=2.07，95%CI=1.13-3.78）、贩毒（aOR=2.40，95%CI=1.27-4.54）和海洛因注射（aOR=2.13，95%CI=1.04-4.38）。
在挪威七个城市开展的一项大规模纳洛酮项目，累计每 10 万人 495 人的分配率表明，高危人群中的纳洛酮饱和度良好，每个城市的项目持续时间是纳洛酮拥有和使用的重要指标。
