Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
Int J Drug Policy. 2022 Apr;102:103615. doi: 10.1016/j.drugpo.2022.103615. Epub 2022 Feb 13.
In 2019-2020, record-high numbers of overdoses have been reported across the UK. We estimated perceived availability to and carriage of naloxone and explored factors associated with carriage among people who inject drugs (PWID) engaged with services in England, Wales, and Northern Ireland.
Participants were PWID enrolled in the Unlinked Anonymous Monitoring Survey in 2019 who reported past-year injection drug use (n = 2,139). Recruitment occurred through specialist and community drug agencies located across the UK, excluding Scotland. Socio-demographic, behavioural and service use characteristics were self-reported. Participants were asked whether they carry naloxone (timeframe unspecified). If they answered "no", they were further asked whether it is available in their area. Perceived naloxone availability and carriage were estimated by requirement region, classified using the Nomenclature of Territorial Units for Statistics 1. We used the Gelberg-Andersen Model of healthcare access to explore predisposing, enabling and need factors associated with regionally-aggregated naloxone carriage.
Perceived naloxone availability was ≥95% in all 11 regions; naloxone carriage varied (mean: 61.1; range: 48%-71%; P<0.01). Among predisposing factors, female gender (adjusted odds ratio (AOR): 1.52; 95% confidence interval (CI): 1.21-1.91) was positively associated with naloxone carriage, whilst recruitment in Yorkshire and the Humber-relative to London-was negatively associated (AOR: 0.55; 95%CI: 0.37-0.82). Among enabling factors, past-year contact with needle and syringe programmes (AOR: 1.74; 95%CI: 1.39-2.18) and currently receiving treatment for drug use (AOR: 1.75; 95%CI: 1.24-2.46) were positively associated with naloxone carriage. Among need characteristics, past-month heroin injection, with or without past-month high-risk drinking or benzodiazepine use, was positively associated with carriage relative to no heroin injection (range of AORs: 1.71-2.58).
Perceived naloxone availability is very high among PWID attending services in England, Wales, and Northern Ireland. Naloxone carriage is moderately high and varying across regions, and appears improved through recent engagement with harm-reduction programs.
2019-2020 年，英国报告了创纪录数量的过量用药事件。我们评估了阿片类药物解毒剂（naloxone）在注射吸毒者（PWID）中的可及性和携带情况，并探讨了与携带相关的因素，这些 PWID 参与了英格兰、威尔士和北爱尔兰的服务。
参与者是 2019 年参加匿名监测调查的过去一年有注射吸毒史的 PWID（n=2139）。招募工作通过位于英国各地的专门和社区毒品机构进行，不包括苏格兰。社会人口统计学、行为和服务使用特征均为自我报告。参与者被问及他们是否携带纳洛酮（未指定时间范围）。如果他们回答“否”，则进一步询问他们所在地区是否有纳洛酮。根据需求地区对纳洛酮的可及性和携带情况进行了估计，使用统计 1 号命名法进行了分类。我们使用 Gelberg-Andersen 医疗保健获取模型来探讨与地区聚合的纳洛酮携带相关的倾向、使能和需求因素。
在所有 11 个地区，纳洛酮的可及性均≥95%；纳洛酮的携带情况各不相同（平均值：61.1%；范围：48%-71%；P<0.01）。在倾向因素中，女性（调整后的优势比（AOR）：1.52；95%置信区间（CI）：1.21-1.91）与纳洛酮携带呈正相关，而在约克郡和亨伯地区的招募（与伦敦相比）与纳洛酮携带呈负相关（AOR：0.55；95%CI：0.37-0.82）。在使能因素中，过去一年与针具交换计划的接触（AOR：1.74；95%CI：1.39-2.18）和目前接受药物使用治疗（AOR：1.75；95%CI：1.24-2.46）与纳洛酮携带呈正相关。在需求特征中，与没有海洛因注射相比，过去一个月有海洛因注射，无论过去一个月是否有高风险饮酒或苯二氮䓬类药物使用，与携带海洛因相关（AOR 范围：1.71-2.58）。
在英格兰、威尔士和北爱尔兰接受服务的注射吸毒者中，纳洛酮的可及性非常高。纳洛酮的携带率较高，且在各地区之间存在差异，通过最近参与减少伤害计划，纳洛酮的携带率有所提高。
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