Troberg Katja, Isendahl Pernilla, Dahlman Disa, Håkansson Anders
Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Malmö Addiction Center, Region Skåne, Sweden.
Harm Reduct J. 2025 Jun 5;22(1):97. doi: 10.1186/s12954-025-01255-3.
Opioid use disorder is a chronic disorder with a high risk of overdose-related morbidity and mortality where a large proportion of these can be averted by timely administration of the antidote naloxone. For naloxone to be present when and where overdoses occur, broad-scale overdose education and naloxone distribution (OEND) must be established. A regional naloxone program was implemented in 2018, in Skåne County, Sweden. This five-year follow-up aims to describe all naloxone-related lay-person events, whether recommendations previously described in the literature were met, and to further investigate events conducted by individuals reporting overdose reversals with naloxone on three or more occasions ('Supersavers').
Between June 2018 and June 2023, data was collected in six-month intervals from 52 participating units, containing information on trained individuals, gender, year of birth and distributed naloxone kits. Upon naloxone replenishment, patients were asked whether previous naloxone had been used for overdose reversals on someone else, or themselves, had been lost, stolen, or given to someone else. Targets for naloxone distribution and program enrolment were set to a minimum of 20 kits per annual opioid overdose death, and 100 individuals at-risk per 100,000 inhabitants, respectively.
Training and initial kits were provided to 2685 individuals at risk of own opioid overdose. Upon refill (n = 2,364), naloxone had been used for overdose reversal in 39% (n = 926) situations. In total, 5900 naloxone kits were distributed. Distribution target in relation to opioid overdose mortality was met annually, while the enrolment target was first met during the second year. The core group of Supersavers represent 9% (n = 50) of participants returning for refill while reporting 54.5% (n = 292) of all overdose reversals.
Broad-scale naloxone training and distribution reaches a large proportion of individuals at risk of opioid overdose. A continuous focus and priority in supporting units with a high prevalence of individuals witnessing overdose events is of great importance as these individuals report a large proportion of overdose reversals. Likewise, it is of great importance to provide these individuals, i.e. Supersavers, with needed and sufficient support for their continued essential work intervening in overdose situations.
Naloxone Treatment in Skåne County- Effect on Drug-related Mortality and Overdose-related Complications, NCT03570099, registered 26 June 2018.
阿片类药物使用障碍是一种慢性疾病，存在与过量用药相关的高发病率和死亡率风险，其中很大一部分可通过及时使用解毒剂纳洛酮来避免。为了在过量用药发生时和发生地点都有纳洛酮可用，必须开展广泛的过量用药教育和纳洛酮分发（OEND）。2018年，瑞典斯科讷郡实施了一项区域性纳洛酮项目。这项为期五年的随访旨在描述所有与纳洛酮相关的非专业人员事件，评估是否符合先前文献中描述的建议，并进一步调查那些报告使用纳洛酮逆转三次或更多次过量用药情况的个人（“超级救助者”）所实施的事件。
在2018年6月至2023年6月期间，每六个月从52个参与单位收集一次数据，内容包括接受培训的个人信息、性别、出生年份以及分发的纳洛酮试剂盒。在补充纳洛酮时，询问患者之前的纳洛酮是否用于逆转他人或自己的过量用药情况，是否丢失、被盗或给了他人。纳洛酮分发和项目注册的目标分别设定为每年每例阿片类药物过量用药死亡至少20个试剂盒，以及每10万居民中有100名高危个体。
为2685名有阿片类药物过量用药风险的个人提供了培训和初始试剂盒。在补充纳洛酮时（n = 共2364例），39%（n = 926例）的情况中纳洛酮被用于逆转过量用药。总共分发了5900个纳洛酮试剂盒。与阿片类药物过量用药死亡率相关的分发目标每年都能实现，而注册目标在第二年首次实现。“超级救助者”核心群体占补充纳洛酮的参与者的9%（n = 50），但报告了所有过量用药逆转情况的54.5%（n = 292）。
广泛的纳洛酮培训和分发覆盖了很大一部分有阿片类药物过量用药风险的个人。持续关注并优先支持目睹过量用药事件发生率高的单位非常重要，因为这些个人报告了很大比例的过量用药逆转情况。同样，为这些个人，即“超级救助者”，提供必要且充分的支持以继续他们在过量用药情况干预中的重要工作也非常重要。
斯科讷郡纳洛酮治疗对药物相关死亡率和过量用药相关并发症的影响，NCT03570099，于2018年6月26日注册。
