Abstract
Background: Injectable naloxone is already provided as take-home naloxone (THN), and new concentrated intranasal naloxone is now being introduced in Europe. Despite evidence of the effectiveness and cost-effectiveness of THN, little is known about the attitudes of key target populations: people who use opioids (PWUO), family/friends, and staff. We examined the acceptability of different naloxone devices (ampoule, prefilled syringe, and concentrated nasal spray) across 5 European countries.
Objectives: The aim of this study was to compare THN target groups (PWUO vs. family/friends vs. staff) in their past rates of witnessed overdose and THN administration (as indicators of future use), current THN device preference, and THN carriage on the day of survey.
Method: Cross-sectional survey of respondents (age ≥18) in addiction treatment, harm reduction, and recovery services in Denmark, England, Estonia, Norway, and Scotland. A purpose-developed questionnaire (59 items) was administered in the local language electronically or in a pen-and-paper format.
Results: Among n = 725 participants, 458 were PWUO (63.2%), 214 staff (29.5%), and 53 (7.3%) family members. The groups differed significantly in their likelihood-of-future THN use (p < 0.001): PWUO had the highest rate of previously witnessing overdoses (352; 77.7%), and staff members reported the highest past naloxone use (62; 30.1%). Across all groups, most respondents (503; 72.4%) perceived the nasal spray device to be the easiest to use. Most reported willingness to use the spray in an overdose emergency (508; 73.5%), followed by the prefilled syringe (457; 66.2%) and ampoules (64; 38.2%). Average THN carriage was 18.6%, ranging from 17.4% (PWUO) to 29.6% (family members).
Conclusion: Respondents considered the concentrated naloxone nasal spray the easiest device to use. Still, most expressed willingness to use the nasal spray as well as the prefilled syringe in an overdose emergency. Carriage rates were generally low, with fewer than 1 in 5 respondents carrying their THN kit on the day of the survey.
| Original language | English |
|---|---|
| Pages (from-to) | 220-225 |
| Number of pages | 6 |
| Journal | European Addiction Research |
| Volume | 28 |
| Issue number | 3 |
| Early online date | 3 Feb 2022 |
| DOIs | |
| Publication status | Published - May 2022 |
Bibliographical note
Funding Information:The authors Katri Abel-Ollo, Shabana Akhtar, Thomas Clausen, Ed Day, Helle Petersen, Andrew McAuley, Martin Sefranek, and Henrik Thiesen have no conflicts of interest to declare. In the past 3 years, Ed Day has taken part in research funded by Indivior and Mundipharma, but he has not received individual honoraria from any organization. Rebecca McDonald's and Sibella Breidahl's research posts at King's College London were partly supported by project-specific research grants to the university from Mundipharma to enable this project. Rebecca McDonald received conference-related travel funding and an honorarium from Improving Opioid Outcomes in the Treatment of Opioid Dependence (IOTOD) in 2018. Rebecca McDonald’s employer (King’s College London) has received a research grant from Mundipharma Research Ltd., for an observational cohort study of THN provision in Europe, on which Rebecca McDonald is partly employed (0.5 FTE). Separately, King’s College London registered intellectual property on a novel buccal naloxone formulation, naming Rebecca McDonald as a coinventor. Rebecca McDonald worked as a consultant on community-based naloxone access in Central Asia and Eastern Europe for the UNODC (2016–17). In the past 3 years, Mike Kelleher has taken part in research funded by Indivior, Camurus, and Mundipharma. He has received honoraria from Indivior, Gilead, and Abbvie. John Strang, through his university, works with the pharmaceutical industry to identify new or improved treatments, and his employer (King’s College London) has received grants, travel costs, and/or consultancy payments; this includes investigation of new naloxone formulations and has included work, within the past 3 years, with Accord Healthcare and Mundipharma (both of whom have naloxone products) including a multi-site observational prospective cohort study of recipients of different forms of THN (research grant support from Mundipharma Research Ltd). His employer (King’s College London) has also registered intellectual property on a novel buccal naloxone formulation, naming John Strang as a coinventor, and he was earlier named in a patent registration by a pharmaceutical company regarding a concentrated nasal naloxone spray. John Strang worked as a consultant on community-based naloxone access in Central Asia and Eastern Europe for the United Nations Office on Drugs and Crime (UNODC; 2016–17). For a fuller account, see John Strang’s webpage at http://www.kcl.ac.uk/ioppn/depts/addictions/people/hod.aspx.
Publisher Copyright:
© 2022
Keywords
- Carriage
- Heroin
- Naloxone
- Nasal
- Opiates
- Opioids
- Overdose
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Health(social science)
- Psychiatry and Mental health
