Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment

Harm Reduction Journal

Brief Report

E. Erin Artigiani¹  Eric D. Wish¹  Daniel Ciccarone²  Johannes Thrul³  Aaron D. Greenblatt⁴  Annabelle M. Belcher⁴  Christopher Welsh⁴  Thomas O. Cole⁴  Zofia Kozak⁴  Donald Gann⁴  Mark Yoon⁵  Alexander L. Pappas⁶ 

[1] Center for Substance Abuse Research, University of Maryland, College Park, MD, USA;Department of Family and Community Medicine, University of California, San Francisco School of Medicine, San Francisco, CA, USA;Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA;Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA;Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia;Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 1001 W. Pratt Street, 21223, Baltimore, MD, USA;Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 1001 W. Pratt Street, 21223, Baltimore, MD, USA;Division of Medical Psychology, Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, 21287, Baltimore, USA;Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 1001 W. Pratt Street, 21223, Baltimore, MD, USA;Venice Family Clinic, Venice, CA, USA;

关键词: Harm reduction;    Naloxone;    Methadone;    Overdose;   

DOI  :  10.1186/s12954-023-00745-6

 received in 2022-05-25, accepted in 2023-01-31,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundDespite the widespread availability of naloxone, US opioid overdose rates continue to rise. The “Cascade of Care” (CoC) is a public health approach that identifies steps in achieving specific outcomes and has been used to identify gaps in naloxone carriage among individuals with opioid use disorder (OUD). We sought to apply this framework to a treatment-seeking population with OUD that may be more inclined to engage in harm reduction behaviors.MethodsPatients were recruited from an urban methadone program to complete a survey. We assessed naloxone familiarity, availability, obtainability, training, and possession, as well as naloxone carriage rates, demographics, and harm reduction behaviors. A multivariable logistic regression examined associations between naloxone carriage and individual-level factors.ResultsParticipants (n = 97) were majority male (59%), with a mean age of 48 (SD = 12), 27% had college education or higher, 64% indicated injection drug use, and 84% reported past naloxone training. All participants endorsed familiarity with naloxone, but only 42% regularly carried naloxone. The following variables were associated with carrying naloxone: White race (aOR = 2.94, 95% CI 1.02–8.52), college education (aOR = 8.11, 95% CI 1.76–37.47), and total number of self-reported harm reduction behaviors (aOR = 1.45, 95% CI 1.00–2.11).ConclusionWe found low rates of naloxone carriage among methadone-treated patients. Methadone programs provide opportunities for naloxone interventions and should target racial/ethnic minorities and individuals with lower education. The spectrum of harm reduction behaviors should be encouraged among these populations to enhance naloxone carriage.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 8