在一组有定期注射吸毒史的被监禁男性中，监狱内带纳洛酮回家方案的可接受性。
Acceptability of prison-based take-home naloxone programmes among a cohort of incarcerated men with a history of regular injecting drug use.
机构信息
Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
出版信息
Harm Reduct J. 2018 Sep 21;15(1):48. doi: 10.1186/s12954-018-0255-5.
BACKGROUND
Take-home naloxone (THN) programmes are an evidence-based opioid overdose prevention initiative. Elevated opioid overdose risk following prison release means release from custody provides an ideal opportunity for THN initiatives. However, whether Australian prisoners would utilise such programmes is unknown. We examined the acceptability of THN in a cohort of male prisoners with histories of regular injecting drug use (IDU) in Victoria, Australia.
METHODS
The sample comprised 380 men from the Prison and Transition Health (PATH) Cohort Study; all of whom reported regular IDU in the 6 months prior to incarceration. We asked four questions regarding THN during the pre-release baseline interview, including whether participants would be willing to participate in prison-based THN. We describe responses to these questions along with relationships between before- and during-incarceration factors and willingness to participate in THN training prior to release from prison.
RESULTS
Most participants (81%) reported willingness to undertake THN training prior to release. Most were willing to resuscitate a friend using THN if they were trained (94%) and to be revived by a trained peer (91%) using THN. More than 10 years since first injection (adjusted odds ratio [AOR] 2.22, 95%CI 1.03-4.77), having witnessed an opioid overdose in the last 5 years (AOR 2.53, 95%CI 1.32-4.82), having ever received alcohol or other drug treatment in prison (AOR 2.41, 95%CI 1.14-5.07) and injecting drugs during the current prison sentence (AOR 4.45, 95%CI 1.73-11.43) were significantly associated with increased odds of willingness to participate in a prison THN programme. Not specifying whether they had injected during their prison sentence (AOR 0.37, 95%CI 0.18-0.77) was associated with decreased odds of willingness to participate in a prison THN training.
CONCLUSION
Our findings suggest that male prisoners in Victoria with a history of regular IDU are overwhelmingly willing to participate in THN training prior to release. Factors associated with willingness to participate in prison THN programmes offer insights to help support the implementation and uptake of THN programmes to reduce opioid-overdose deaths in the post-release period.
背景
带离式纳洛酮（THN）计划是一项基于证据的阿片类药物过量预防举措。由于囚犯在出狱后面临更高的阿片类药物过量风险，因此出狱成为实施 THN 计划的理想时机。然而，澳大利亚囚犯是否会接受此类计划尚不清楚。我们在澳大利亚维多利亚州的一个曾有规律注射吸毒史（IDU）的男性囚犯队列中，调查了 THN 的可接受性。
方法
该样本包括来自监狱和过渡健康（PATH）队列研究的 380 名男性；他们在入狱前的 6 个月内均有规律的 IDU。我们在出狱前的基线访谈中询问了他们关于 THN 的四个问题，包括他们是否愿意参加监狱内的 THN。我们描述了对这些问题的回答，以及入狱前后因素与在出狱前参加 THN 培训的意愿之间的关系。
结果
大多数参与者（81%）表示愿意在出狱前参加 THN 培训。如果接受培训，大多数人愿意使用 THN 抢救朋友（94%），并愿意接受接受过培训的同伴使用 THN 进行复苏（91%）。超过 10 年的首次注射（调整后的优势比[OR] 2.22，95%CI 1.03-4.77），在过去 5 年内目睹过阿片类药物过量（OR 2.53，95%CI 1.32-4.82），在监狱中曾接受过酒精或其他药物治疗（OR 2.41，95%CI 1.14-5.07）以及在当前监狱服刑期间注射毒品（OR 4.45，95%CI 1.73-11.43），与参加监狱 THN 计划的意愿增加显著相关。未说明在监狱服刑期间是否注射过毒品（OR 0.37，95%CI 0.18-0.77）与参加监狱 THN 培训的意愿降低相关。
结论
我们的研究结果表明，维多利亚州有规律的 IDU 史的男性囚犯绝大多数愿意在出狱前参加 THN 培训。与参加监狱 THN 计划意愿相关的因素提供了一些见解，有助于支持 THN 计划的实施和推广，以减少出狱后阿片类药物过量死亡。
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