Hikma Pharmaceuticals USA Inc, Berkeley Heights, NJ, USA.
Hikma Specialty USA Inc, Berkeley Heights, NJ, USA.
Subst Abus. 2022;43(1):1075-1084. doi: 10.1080/08897077.2022.2060433.
The increasing rates of highly potent, illicit synthetic opioids (i.e., fentanyl) in the US is exacerbating the ongoing opioid epidemic. Multiple naloxone administrations (MNA) may be required to successfully reverse opioid overdoses. We conducted a real-world study to assess the rate of MNA for opioid overdose and identify factors associated with MNA. : Data from the 2015-2020 National Emergency Medical Services Information System was examined to determine trends in events requiring MNA. Logistic regression analysis was performed to determine factors associated with MNA. : The percentage of individuals receiving MNA increased from 18.4% in 2015 to 28.4% in 2020. The odds of an event requiring MNA significantly increased by 11% annually. The adjusted odds ratio (aOR) for MNA were greatest among males, when advanced life support (ALS) was provided, and when the dispatch complaint indicated there was a drug poisoning event. : The 54% increase in MNA since 2015 parallels the rise in overdose deaths attributable to synthetic opioids. This growth is visible in all regions of the country, including the West, where the prevalence of illicitly manufactured synthetic opioids is intensifying. Given this phenomenon, higher naloxone formulations may fulfill an unmet need in addressing the opioid overdose crisis.
美国高效力、非法合成阿片类药物（即芬太尼）的使用率不断上升，加剧了阿片类药物泛滥的现状。为成功逆转阿片类药物过量，可能需要多次给予纳洛酮。我们开展了一项真实世界研究，旨在评估阿片类药物过量时给予纳洛酮的比例，并确定与纳洛酮相关的因素。： 我们分析了 2015 年至 2020 年国家紧急医疗服务信息系统的数据，以确定需要多次给予纳洛酮的事件趋势。采用逻辑回归分析确定与纳洛酮相关的因素。： 接受多次纳洛酮治疗的人数比例从 2015 年的 18.4%上升至 2020 年的 28.4%。每年需要多次给予纳洛酮的事件发生几率增加 11%。当事件涉及男性、提供高级生命支持（ALS）和调度投诉表明存在药物中毒事件时，多次给予纳洛酮的调整后比值比（aOR）最高。： 自 2015 年以来，多次给予纳洛酮的比例增加了 54%，同期归因于合成阿片类药物的过量死亡人数也有所增加。这种增长在全美各地都可见，包括非法制造合成阿片类药物日益猖獗的西部地区。鉴于这种现象，更高剂量的纳洛酮可能会满足解决阿片类药物过量危机的未满足需求。
