Fleißner Simon, Steimle Larissa, Schäffer Dirk, Werse Bernd, Deimel Daniel, Kuban Maria, Stöver Heino
Faculty of Social Sciences, Technical University Nuernberg Georg Simon Ohm, Keßlerplatz 12, 90489, Nuremberg, Germany.
Institute of Addiction Research, Frankfurt University of Applied Sciences, Nibelungenplatz 1, 60318, Frankfurt a.M, Germany.
Harm Reduct J. 2025 Jul 18;22(1):120. doi: 10.1186/s12954-025-01281-1.
Take-home naloxone (THN) can prevent deaths related to opioid overdoses. Despite the first THN project in Germany in 1998, the availability of naloxone for people who use opioids (PWUO) is still scarce. We present the results of the German-wide THN-project NALtrain, which aimed to implement THN nationwide. Firstly, we present data collected during NALtrain and secondly, we use this data to critically reflect on the project and thereby draw conclusions that could inform future THN projects.
NALtrain was conducted between July 2021 and June 2024. Descriptive statistical analysis of the documentation of 74 train-the-trainer events and following naloxone trainings conducted by the trained staff were carried out.
864 staff members from approximately 373 organizations (mainly harm reduction services) participated in 74 train-the-trainer courses. Of the 373 organizations 123 conducted 784 naloxone trainings for PWUO and reached 2,333 PWUO, of whom 1,451 received THN. The goal of training 800 staff members was met, while the goals of reaching 400 organizations and 10,000 PWUO were missed. The implementation of THN is unevenly distributed across the German federal states, especially concentrated in Bavaria. The core learnings are that the prescription-only status of THN leads to extra organizational efforts and hinders the availability of THN for individuals with the highest risk of overdose.
Considering the proportion of organizations offering THN, they can still be classified as "early adopters". These may serve as role models for the broader majority. Free available THN and centrally coordinated support of implementation including recurring follow-up can be key to a broader availability of THN in Germany. In future initiatives physicians and medical settings should be prioritized.
纳洛酮带回家计划（THN）可预防与阿片类药物过量相关的死亡。尽管德国在1998年开展了首个THN项目，但阿片类药物使用者（PWUO）可获得的纳洛酮仍然稀缺。我们展示了德国范围内的THN项目NALtrain的结果，该项目旨在在全国范围内实施THN。首先，我们展示在NALtrain期间收集的数据，其次，我们利用这些数据对该项目进行批判性反思，从而得出可为未来THN项目提供参考的结论。
NALtrain于2021年7月至2024年6月进行。对74次培训培训师活动以及由受过培训的工作人员随后开展的纳洛酮培训的文档进行描述性统计分析。
来自约373个组织（主要是减少伤害服务机构）的864名工作人员参加了74次培训培训师课程。在这373个组织中，123个为PWUO开展了784次纳洛酮培训，覆盖了2333名PWUO，其中1451人获得了THN。培训800名工作人员的目标得以实现，而覆盖400个组织和10000名PWUO的目标未达成。THN的实施在德国联邦各州分布不均，尤其集中在巴伐利亚州。核心经验是，THN仅凭处方获取的状态导致额外的组织工作，并阻碍了纳洛酮对于过量用药风险最高的个人的可及性。
考虑到提供THN的组织比例，它们仍可被归类为“早期采用者”。这些组织可成为更广泛多数组织的榜样。免费提供THN以及包括定期跟进在内的中央协调实施支持可能是THN在德国更广泛可及的关键。在未来的举措中，应优先考虑医生和医疗机构。
