Department of Economics, University of Iowa, Iowa City, USA.
Rural Drug Addiction Research Center, University of Nebraska-Lincoln, Oldfather Hall - 4th Floor, 660 N 12th Street, Lincoln, NE, 68588, USA.
Harm Reduct J. 2024 Feb 10;21(1):37. doi: 10.1186/s12954-024-00954-7.
The rising prevalence of fast-acting opioids in the USA suggests the increased need for non-professional first responder administration of naloxone. Effective administration of naloxone during an overdose requires that bystanders are familiar with, have access to, and know how to use naloxone.
Drawing on a statewide, address-based sample of Nebraskan adults, we used logistic regression to predict the likelihood of respondents' familiarity with, access to, and competency to administer naloxone. Our independent variables included measures indicating proximity to drug use, perceived community stigma toward people who use drugs, and demographic data.
There were significant gaps in naloxone knowledge in Nebraska. Although 74.8% of respondents were familiar with naloxone, only 18.2% knew how to access it and 18.0% knew how to use it. Being close to an overdose experience, lifetime illicit opioid use, being close to a person who uses opioids, and having access to illicit opioids were not significantly associated with naloxone familiarity, access, or competency among respondents in Nebraska's two largest cities, Omaha and Lincoln. Outside of these cities, being close to a past overdose experience and access to illicit opioids was associated with higher odds of naloxone access and competency, but lifetime opioid use and being close to a person who uses opioids were not. Finally, among those familiar with naloxone, a higher perception of community stigma toward people who use opioids generally was associated with lower odds of naloxone access and competency. Higher perception of community stigma toward people who use heroin, methamphetamines, and cocaine, however, was associated with higher odds of naloxone access.
Our findings highlight the continued need for education on naloxone with a specific focus on access and competency to further reduce opioid-related overdose deaths. Specific focus should be placed on promoting naloxone knowledge among people with a higher likelihood of needing to administer naloxone to reduce otherwise avoidable deaths. Further work is needed to understand differences in the relationship between substance-specific perceived stigma and its association with naloxone access.
美国速效阿片类药物的流行率不断上升，表明非专业急救人员需要更多地管理纳洛酮。在过量服用期间有效地管理纳洛酮需要旁观者熟悉、可以获得并知道如何使用纳洛酮。
我们利用内布拉斯加州全州范围内基于地址的成年人样本，使用逻辑回归预测受访者对纳洛酮的熟悉程度、获取途径和管理能力的可能性。我们的自变量包括表明接近毒品使用的指标、对使用毒品者的社区污名化感知，以及人口统计学数据。
在内布拉斯加州，纳洛酮知识存在显著差距。尽管 74.8%的受访者熟悉纳洛酮，但只有 18.2%知道如何获取，18.0%知道如何使用。接近过量服用经历、终身非法使用阿片类药物、接近使用阿片类药物的人，以及获得非法阿片类药物，与内布拉斯加州两个最大城市奥马哈和林肯的受访者对纳洛酮的熟悉度、获取途径或管理能力没有显著关联。在这些城市之外，接近过去的过量服用经历和获得非法阿片类药物与纳洛酮获取和管理能力的几率更高相关，但终身阿片类药物使用和接近使用阿片类药物的人没有。最后，在熟悉纳洛酮的人群中，对使用阿片类药物者的社区污名化感知普遍较高，与纳洛酮获取和管理能力的几率较低相关。然而，对使用海洛因、冰毒和可卡因者的社区污名化感知较高，与纳洛酮获取的几率较高相关。
我们的研究结果突出表明，需要继续开展纳洛酮教育，特别关注获取和管理能力，以进一步减少阿片类药物相关的过量死亡。应特别注重在更有可能需要管理纳洛酮以减少否则可避免的死亡的人群中推广纳洛酮知识。需要进一步努力来理解物质特异性感知污名化与其与纳洛酮获取之间关系的差异。
