Fleißner Simon, Stöver Heino, Schäffer Dirk, Wodarz-von Essen Heike, Deimel Daniel, Wodarz Norbert
Nuremberg Institute of Technology Georg Simon Ohm, Faculty of Social Science, Nuremberg, Germany; Institute of Addiction Research Frankfurt, Frankfurt University of Applied Sciences, Frankfurt am Main, Germany; Deutsche Aidshilfe, Berlin, Germany; Center for Addiction Medicine, Department of Psychiatry and Psychotherapy of the University Regensburg at the Bezirksklinikum Regensburg, Regensburg, Germany.
Dtsch Arztebl Int. 2025 May 2;122(9):240-244. doi: 10.3238/arztebl.m2025.0030.
There were 2227 drug-related deaths in Germany in 2023, corresponding to a rise of 12% over the previous year and a doubling over the course of a decade. Approximately 60% of these deaths were related to opioid consumption. In this narrative review, we discuss whether take-home naloxone (THN) might lower the mortality of persons with opioid dependency.
This review is based on pertinent publications that were retrieved by a selective search in PubMed.
Seven observational studies of the mortality of persons with opioid dependency were included in the analysis. The available evidence for the intervention is on a low level. The studies indicate an overall lowering of mortality even though a significant reduction in drug-related deaths was not always achieved. It was concluded in a meta-analysis of 9 observational studies that 9.2% (95% confidence interval, [5.2; 13.1]) of the THN kits provided were actually used in the first three months to prevent opioid overdose-related death. In a Canadian study, 43% [41; 45] of the naloxone kits that were handed out over a period of 8 years were used and successfully prevented opioid overdose-related death. The latter figures suggest that the use of THN may have been systematically underestimated to date.
Demonstrating the efficacy of THN is difficult because of the nature of the research topic. Current evidence implies that THN lowers the mortality of persons with opioid dependence. It is estimated that only about 1.3% of opioid dependent people have been provided with THN in Germany thus far. A major expansion of the provision and use of THN could contribute to a further reduction in opioid-related deaths.
2023年德国有2227例与药物相关的死亡，较上一年增长了12%，且在十年间翻倍。这些死亡中约60%与阿片类药物消费有关。在这篇叙述性综述中，我们讨论居家使用纳洛酮（THN）是否可能降低阿片类药物依赖者的死亡率。
本综述基于通过在PubMed中进行选择性检索获得的相关出版物。
分析纳入了七项关于阿片类药物依赖者死亡率的观察性研究。该干预措施的现有证据水平较低。这些研究表明总体死亡率有所降低，尽管并非总能显著减少与药物相关的死亡。在一项对9项观察性研究的荟萃分析中得出结论，所提供的THN试剂盒中有9.2%（95%置信区间，[5.2；13.1]）在头三个月实际用于预防与阿片类药物过量相关的死亡。在一项加拿大研究中，在8年期间发放的纳洛酮试剂盒中有43%[41；45]被使用，并成功预防了与阿片类药物过量相关的死亡。后一组数据表明，迄今为止THN的使用可能被系统性低估了。
由于研究主题的性质，证明THN的疗效很困难。目前的证据表明THN可降低阿片类药物依赖者的死亡率。据估计，迄今为止德国只有约1.3%的阿片类药物依赖者获得了THN。大幅扩大THN的供应和使用可能有助于进一步减少与阿片类药物相关的死亡。
