The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia.
The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Int J Drug Policy. 2021 Oct;96:103421. doi: 10.1016/j.drugpo.2021.103421. Epub 2021 Aug 25.
Overdose is a major cause of morbidity and mortality among people who use opioids. Naloxone can reverse opioid overdoses and can be distributed and administered with minimal training. People with experience of overdose are a key population to target for overdose prevention strategies. This study aims to understand if factors associated with recent non-fatal opioid overdose are the same as factors associated with naloxone access and naloxone training in people who recently used opioids or received opioid agonist treatment (OAT).
ETHOS Engage is an observational study of people who inject drugs in Australia. Logistic regression models were used to estimate odds ratios for non-fatal opioid overdose, naloxone access and naloxone training.
Between May 2018-September 2019, 1280 participants who recently used opioids or received OAT were enrolled (62% aged >40 years; 35% female, 80% receiving OAT, 62% injected drugs in the preceding month). Recent opioid overdose (preceding 12 months) was reported by 7% of participants, lifetime naloxone access by 17%, and lifetime naloxone training by 14%. Compared to people receiving OAT with no additional opioid use, recent opioid, benzodiazepine (preceding six months), and hazardous alcohol use was associated with recent opioid overdose (aOR 3.91; 95%CI: 1.68-9.10) and lifetime naloxone access (aOR 2.12; 95%CI 1.29-3.48). Among 91 people who reported recent overdose, 65% had never received take-home naloxone or naloxone training.
Among people recently using opioids or receiving OAT, benzodiazepine and hazardous alcohol use is associated with non-fatal opioid overdose. Not all factors associated with non-fatal overdose correspond to factors associated with naloxone access. Naloxone access and training is low across all groups. Additional interventions are needed to scale up naloxone provision.
阿片类药物使用者的药物过量是发病率和死亡率的主要原因。纳洛酮可以逆转阿片类药物过量，并且可以在经过最少的培训后进行分发和管理。有药物过量经历的人是针对药物过量预防策略的关键人群。本研究旨在了解与近期非致命性阿片类药物过量相关的因素是否与最近使用阿片类药物或接受阿片类激动剂治疗（OAT）的人中与纳洛酮获取和纳洛酮培训相关的因素相同。
ETHOS Engage 是一项针对澳大利亚注射吸毒者的观察性研究。使用逻辑回归模型估计非致命性阿片类药物过量、纳洛酮获取和纳洛酮培训的比值比。
在 2018 年 5 月至 2019 年 9 月期间，共纳入 1280 名最近使用阿片类药物或接受 OAT 的参与者（62%年龄>40 岁；35%女性，80%接受 OAT，62%在过去一个月内注射药物）。7%的参与者报告了最近的阿片类药物过量（过去 12 个月），17%的参与者有过纳洛酮获取，14%的参与者接受过纳洛酮培训。与仅接受 OAT 且无额外阿片类药物使用的参与者相比，最近使用阿片类药物、苯二氮䓬类药物（过去六个月）和有害性酒精使用与最近的阿片类药物过量（aOR 3.91；95%CI：1.68-9.10）和纳洛酮获取（aOR 2.12；95%CI：1.29-3.48）相关。在 91 名报告最近有过量用药的参与者中，65%从未接受过纳洛酮或纳洛酮培训。
在最近使用阿片类药物或接受 OAT 的人群中，苯二氮䓬类药物和有害性酒精使用与非致命性阿片类药物过量有关。与非致命性过量相关的因素并非都与纳洛酮获取相关。所有人群的纳洛酮获取和培训率都很低。需要采取更多干预措施来扩大纳洛酮的供应。
