School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, BC, Canada; HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
British Columbia Centre for Disease Control, Vancouver, BC, Canada.
Int J Drug Policy. 2019 Sep;71:157-163. doi: 10.1016/j.drugpo.2019.01.006. Epub 2019 Jan 25.
British Columbia (BC), Canada, is experiencing an unprecedented number of opioid overdoses mainly due to the contamination of illicit drugs with fentanyl and its analogues. Reluctance to seek emergency medical help (i.e., by calling 9-1-1) has been identified as a barrier to optimal care for overdose victims. This study aimed to identify the correlates of seeking help during an overdose event when naloxone was administered via BC's Take Home Naloxone (THN) program.
In this cross-sectional study, we reviewed administrative records (from July 2015 to December 2017) about overdose events submitted by THN participants when they received their replacement naloxone kits (n = 2350). The primary outcome of the study was reported calling 9-1-1 and modified Poisson regression models were built to investigate the factors associated with help-seeking during an overdose event.
Most overdose victims were men (69.0%) and >30 years old (61.5%). Overall, participants reported calling 9-1-1 in 1310 (55.7%) overdose events. In the multivariable model, the likelihood of calling 9-1-1 was significantly and positively associated with the overdose victim being male and receiving rescue breathing. The likelihood of calling 9-1-1 was significantly and negatively associated with the overdoses occurring in private residences and health regions other than Vancouver Coastal which delivers services to mostly urban residents.
Overall, medical help was sought for 55.7% of overdoses where naloxone was administered. Overdoses occurring among male victims as well as those receiving higher doses of naloxone and mouth-to-mouth rescue breathing were associated with a higher likelihood of help-seeking by responders. Future interventions need to encourage people who witness an overdose to seek emergency medical help.
加拿大不列颠哥伦比亚省（BC）正经历着前所未有的阿片类药物过量事件，主要是由于非法药物中芬太尼及其类似物的污染。人们不愿意寻求紧急医疗救助（即拨打 9-1-1）已被确定为过量用药者获得最佳护理的障碍。本研究旨在确定当通过不列颠哥伦比亚省的带回家纳洛酮（THN）计划给予纳洛酮时，在过量用药事件中寻求帮助的相关因素。
在这项横断面研究中，我们回顾了 THN 参与者在收到替代纳洛酮套件时提交的（2015 年 7 月至 2017 年 12 月）关于过量用药事件的行政记录（n=2350）。该研究的主要结果是报告拨打 9-1-1，并且建立了修正泊松回归模型来调查与过量用药事件中寻求帮助相关的因素。
大多数过量用药受害者是男性（69.0%）和年龄超过 30 岁（61.5%）。总体而言，参与者在 1310 次（55.7%）过量用药事件中报告拨打了 9-1-1。在多变量模型中，拨打 9-1-1 的可能性与过量用药受害者是男性和接受复苏呼吸显著正相关。拨打 9-1-1 的可能性与在私人住宅和温哥华沿海以外的卫生区域发生的过量用药事件显著负相关，后者为主要城市居民提供服务。
总体而言，在给予纳洛酮的 55.7%的过量用药事件中寻求了医疗帮助。在接受纳洛酮剂量较高和进行口对口复苏呼吸的男性受害者中发生的过量用药事件与寻求响应者帮助的可能性更高相关。未来的干预措施需要鼓励目睹过量用药的人寻求紧急医疗救助。
