University of Stirling, Salvation Army Centre for Addiction Services and Research, Colin Bell Building, Stirling, FK9 4LA, Scotland.
Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, Scotland.
Int J Drug Policy. 2021 Oct;96:103298. doi: 10.1016/j.drugpo.2021.103298. Epub 2021 May 30.
Drug-related deaths globally are increasing year on year, with the largest proportion of these being opioid-related. The opioid antagonist naloxone distributed for take-home use ('Take-Home Naloxone (THN)') has been championed as one method of tackling this public health crisis, however to be effective it must be available at an opioid overdose. Ownership and carriage are therefore fundamental to THN success. This study aimed to assess the prevalence of ownership and carriage of THN internationally among people who use drugs (PWUD).
NHS Scotland Journals, AMED, EMBASE, HMIC, MEDLINE, PsycINFO, CINAHL Complete, PubMed, Cochrane Library, PROSPERO and grey literature were searched for articles which measured prevalence of THN ownership or carriage between 1996 and 2020. Ownership was defined as report of a personal supply of THN. Carriage was defined as the participant carrying THN on their person at time of data collection or reporting a frequency of how often they carry THN. Risk of bias was evaluated using the Joanna Briggs Checklist for Prevalence Studies.
Systematic search yielded 6363 papers, with ten eligible papers identified. Eight articles were included in ownership prevalence and five articles included for carriage prevalence, with an overlap of three studies between both measures. Pooled prevalence indicated moderate ownership levels (57%, CI 47-67%) but lower carriage levels (20%, CI 12-31%). Analysis was complicated by the limited number of available studies and lack of standardised terminology and measurement.
Understanding naloxone ownership and carriage globally is hampered by limited evidence and heterogeneity across studies. From the available data, prevalence of THN carriage overall appears low, despite moderate ownership. Given the variation across studies, future research should seek to utilise more standardised terminology and methods of measurement. Furthermore, services distributing THN must ensure the importance of regular carriage of naloxone is consistently emphasised.
全球与药物相关的死亡人数逐年增加，其中大部分与阿片类药物有关。纳洛酮作为一种解决这一公共卫生危机的方法，已被广泛应用，这种阿片类药物拮抗剂已被分发供家庭使用（“家庭用纳洛酮（THN）”）。然而，要使其有效，就必须在阿片类药物过量时提供。因此，拥有和携带纳洛酮是 THN 成功的基础。本研究旨在评估国际上吸毒者（PWUD）拥有和携带 THN 的流行率。
从 1996 年至 2020 年，我们在 NHS 苏格兰期刊、AMED、EMBASE、HMIC、MEDLINE、PsycINFO、CINAHL Complete、PubMed、Cochrane 图书馆、PROSPERO 和灰色文献中搜索了测量 THN 拥有率或携带率的文章。拥有被定义为报告个人供应 THN。携带被定义为参与者在数据收集时携带 THN 或报告携带 THN 的频率。使用 Joanna Briggs 流行率研究清单评估偏倚风险。
系统搜索产生了 6363 篇论文，其中有 10 篇符合条件的论文。8 篇文章纳入了拥有率的研究，5 篇文章纳入了携带率的研究，有 3 项研究同时涉及这两个指标。汇总的流行率表明拥有率处于中等水平（57%，CI 47-67%），但携带率较低（20%，CI 12-31%）。分析受到可用研究数量有限以及术语和测量缺乏标准化的限制。
由于证据有限且研究之间存在异质性，全球范围内对纳洛酮的拥有和携带情况的了解受到阻碍。根据现有数据，总体上 THN 携带率似乎较低，尽管拥有率处于中等水平。鉴于研究之间的差异，未来的研究应努力使用更标准化的术语和测量方法。此外，分发 THN 的服务必须确保始终强调定期携带纳洛酮的重要性。
