Widespread naloxone distribution not enough to impact overdose death rate: Study

The best ever variety of opioid-related overdose deaths in the US was recorded in 2020 at 68,630, a 68% improve in simply two years. Naloxone is a medication that may quickly reverse an opioid overdose, however a brand new examine out of the College of Cincinnati finds that widespread neighborhood distribution of naloxone by way of a take-home naloxone (THN) program didn’t considerably impression the median month-to-month opioid overdose charges.

The examine was revealed in PLOS ONE.

The Naloxone Distribution Collaborative (NDC) was facilitated from October 2017 by way of December 2019 by Hamilton County Public Well being (HCPH). Opioid overdose mortality was in contrast between the interval earlier than (Oct. 2015–Sep. 2017) and through (Oct. 2017–Sep. 2019) this system. Previous to the beginning of this system, there was little distribution of THN to people in Hamilton County.

“Our objective with the naloxone distribution collaborative was to see what occurs if we may saturate a whole neighborhood and see what impression which may have on the opioid overdose charges,” says Caroline Freiermuth, MD, Endowed Chair to Profit the Acute Therapy of Psychological Well being and Substance Use Dysfunction within the Division of Emergency Medication on the UC School of Medication. “We appeared to see what impression broad distribution of naloxone had on the neighborhood and what we discovered that it held opioid overdose dying charges regular.”

HCPH managed naloxone stock, recruited distribution websites and distributed cartons immediately by way of neighborhood occasions and well being division service areas similar to a syringe service program or native jail. Partnering websites had been chosen based mostly on their interactions with individuals in danger for opioid overdose, individuals who might work together with these in danger for opioid overdose, community involvement and willingness to take part. To be included within the examine, naloxone cartons needed to have documentation of both distribution to a person from a web site in Hamilton County, or distribution to a person with a reported residence inside Hamilton County.

Freiermuth says after seeing the examine outcomes displaying no vital change within the opioid overdose dying fee, they went again and modeled what would have occurred had that stage of naloxone provide been out there to the neighborhood to foretell the opioid dying fee to be.

“In case you do this prediction modeling, we’d have thought the opioid dying fee would preserve climbing,” she says. “We noticed that all through the nation and all through Ohio, whereas right here in Hamilton County we just about held regular. Granted there have been many different issues occurring in our county that in all probability contributed to that, however we prefer to assume that not less than a bit of that was naloxone was extra broadly out there.”

The THN effort in Hamilton County ended on the conclusion of 2019, and Freiermuth says the supply of naloxone has been evolving since then. Challenge DAWN (Deaths Prevented with Naloxone) is a community of opioid overdose training and naloxone distribution packages by way of the Ohio Division of Well being that makes an attempt to get naloxone out in the neighborhood as extensively as doable by distributing it to neighborhood businesses who then distribute it to people. Plus, she says, naloxone is being made out there over-the-counter, so that’s one other manner individuals who wish to have it available can acquire it.

The NDC was a profitable effort to extend entry to Narcan in the neighborhood, in keeping with Darci Smith, director of hurt discount for HCPH.

“Growing the quantity of Narcan out there in the neighborhood will increase alternatives to save lots of lives and helps cut back the stigma related to substance use disorder and carrying Narcan,” she says. “The NDC helped lay the muse for our present naloxone training and distribution efforts.”

With the backdrop of September being Nationwide Restoration Month, Freiermuth says one of many greatest hopes with the examine is that it continues to assist fight the stigma.

“There’s nonetheless a variety of stigma round opioid use dysfunction and individuals who use medicine,” she says. “In case you speak to individuals who use medicine, they do not wish to carry naloxone as a result of there is a stigma related to that. It is attention-grabbing as a result of folks will acknowledge that they’re in danger for overdose but nonetheless not at all times carry the remedy due to that exterior image. We hope for folks to ask for this remedy, for folks to be extra conscious that they could want to make use of it and that it isn’t simply homeless folks or these with psychological well being illness who’re utilizing medicine.”