More than just availability: Who has access and who administers take-home naloxone in Baltimore, MD

Research output: Contribution to journalArticle

Abstract

Background Fatal opioid overdose is a pressing public health concern in the United States. Addressing barriers and augmenting facilitators to take-home naloxone (THN) access and administration could expand program reach in preventing fatal overdoses. Methods THN access (i.e., being prescribed or receiving THN) was assessed in a Baltimore, Maryland-based sample of 577 people who use opioids (PWUO) and had a history of injecting drugs. A sub-analysis examined correlates of THN administration among those with THN access and who witnessed an overdose (N = 345). Logistic generalized estimating equations with robust standard errors were used to identify facilitators and barriers to accessing and using THN. Results The majority of PWUO (66%) reported THN access. In the multivariable model, decreased THN access was associated with the fear that a person may become aggressive after being revived with THN (aOR: 0.55, 95% CI: 0.35–0.85), police threaten people at an overdose event (aOR: 0.68, 95% CI: 0.36–1.00), and insufficient overdose training (aOR: 0.43, 95% CI: 0.28–0.68). Enrollment in medication-assisted treatment, personally experiencing an overdose, and graduating from high school were associated with higher access. About half (49%) of PWUO with THN access and who had witnessed an overdose reported having administered THN. THN use was positively associated with “often” or “always” carrying THN (aOR: 3.47, 95% CI: 1.99–6.06), witnessing more overdoses (aOR:5.18, 95% CI: 2.22–12.07), experiencing recent homelessness, and injecting in the past year. THN use was reduced among participants who did not feel that they had sufficient overdose training (aOR: 0.56, 95% CI: 0.32–0.96). Conclusion THN programs must bolster confidence in administering THN and address barriers to use, such as fear of a THN recipient becoming aggressive. Normative change around carrying THN is an important component in an overdose prevention strategy.

Original languageEnglish (US)
Article numbere0224686
JournalPloS one
Volume14
Issue number11
DOIs
StatePublished - Jan 1 2019

Fingerprint

naloxone
Baltimore
Naloxone
Availability
overdose
narcotics
Opioid Analgesics
fearfulness
Fear
homeless people
Homeless Persons
police
high schools

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

More than just availability : Who has access and who administers take-home naloxone in Baltimore, MD. / Dayton, Lauren; Gicquelais, Rachel E.; Tobin, Karin; Davey-Rothwell, Melissa; Falade-Nwulia, Oluwaseun; Kong, Xiangrong; Fingerhood, Michael; Jones, Abenaa A.; Latkin, Carl.

In: PloS one, Vol. 14, No. 11, e0224686, 01.01.2019.

Research output: Contribution to journalArticle

@article{b9b4c7e498294798874cfc41fc37694c,
title = "More than just availability: Who has access and who administers take-home naloxone in Baltimore, MD",
abstract = "Background Fatal opioid overdose is a pressing public health concern in the United States. Addressing barriers and augmenting facilitators to take-home naloxone (THN) access and administration could expand program reach in preventing fatal overdoses. Methods THN access (i.e., being prescribed or receiving THN) was assessed in a Baltimore, Maryland-based sample of 577 people who use opioids (PWUO) and had a history of injecting drugs. A sub-analysis examined correlates of THN administration among those with THN access and who witnessed an overdose (N = 345). Logistic generalized estimating equations with robust standard errors were used to identify facilitators and barriers to accessing and using THN. Results The majority of PWUO (66{\%}) reported THN access. In the multivariable model, decreased THN access was associated with the fear that a person may become aggressive after being revived with THN (aOR: 0.55, 95{\%} CI: 0.35–0.85), police threaten people at an overdose event (aOR: 0.68, 95{\%} CI: 0.36–1.00), and insufficient overdose training (aOR: 0.43, 95{\%} CI: 0.28–0.68). Enrollment in medication-assisted treatment, personally experiencing an overdose, and graduating from high school were associated with higher access. About half (49{\%}) of PWUO with THN access and who had witnessed an overdose reported having administered THN. THN use was positively associated with “often” or “always” carrying THN (aOR: 3.47, 95{\%} CI: 1.99–6.06), witnessing more overdoses (aOR:5.18, 95{\%} CI: 2.22–12.07), experiencing recent homelessness, and injecting in the past year. THN use was reduced among participants who did not feel that they had sufficient overdose training (aOR: 0.56, 95{\%} CI: 0.32–0.96). Conclusion THN programs must bolster confidence in administering THN and address barriers to use, such as fear of a THN recipient becoming aggressive. Normative change around carrying THN is an important component in an overdose prevention strategy.",
author = "Lauren Dayton and Gicquelais, {Rachel E.} and Karin Tobin and Melissa Davey-Rothwell and Oluwaseun Falade-Nwulia and Xiangrong Kong and Michael Fingerhood and Jones, {Abenaa A.} and Carl Latkin",
year = "2019",
month = "1",
day = "1",
doi = "10.1371/journal.pone.0224686",
language = "English (US)",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "11",

}

TY - JOUR

T1 - More than just availability

T2 - Who has access and who administers take-home naloxone in Baltimore, MD

AU - Dayton, Lauren

AU - Gicquelais, Rachel E.

AU - Tobin, Karin

AU - Davey-Rothwell, Melissa

AU - Falade-Nwulia, Oluwaseun

AU - Kong, Xiangrong

AU - Fingerhood, Michael

AU - Jones, Abenaa A.

AU - Latkin, Carl

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background Fatal opioid overdose is a pressing public health concern in the United States. Addressing barriers and augmenting facilitators to take-home naloxone (THN) access and administration could expand program reach in preventing fatal overdoses. Methods THN access (i.e., being prescribed or receiving THN) was assessed in a Baltimore, Maryland-based sample of 577 people who use opioids (PWUO) and had a history of injecting drugs. A sub-analysis examined correlates of THN administration among those with THN access and who witnessed an overdose (N = 345). Logistic generalized estimating equations with robust standard errors were used to identify facilitators and barriers to accessing and using THN. Results The majority of PWUO (66%) reported THN access. In the multivariable model, decreased THN access was associated with the fear that a person may become aggressive after being revived with THN (aOR: 0.55, 95% CI: 0.35–0.85), police threaten people at an overdose event (aOR: 0.68, 95% CI: 0.36–1.00), and insufficient overdose training (aOR: 0.43, 95% CI: 0.28–0.68). Enrollment in medication-assisted treatment, personally experiencing an overdose, and graduating from high school were associated with higher access. About half (49%) of PWUO with THN access and who had witnessed an overdose reported having administered THN. THN use was positively associated with “often” or “always” carrying THN (aOR: 3.47, 95% CI: 1.99–6.06), witnessing more overdoses (aOR:5.18, 95% CI: 2.22–12.07), experiencing recent homelessness, and injecting in the past year. THN use was reduced among participants who did not feel that they had sufficient overdose training (aOR: 0.56, 95% CI: 0.32–0.96). Conclusion THN programs must bolster confidence in administering THN and address barriers to use, such as fear of a THN recipient becoming aggressive. Normative change around carrying THN is an important component in an overdose prevention strategy.

AB - Background Fatal opioid overdose is a pressing public health concern in the United States. Addressing barriers and augmenting facilitators to take-home naloxone (THN) access and administration could expand program reach in preventing fatal overdoses. Methods THN access (i.e., being prescribed or receiving THN) was assessed in a Baltimore, Maryland-based sample of 577 people who use opioids (PWUO) and had a history of injecting drugs. A sub-analysis examined correlates of THN administration among those with THN access and who witnessed an overdose (N = 345). Logistic generalized estimating equations with robust standard errors were used to identify facilitators and barriers to accessing and using THN. Results The majority of PWUO (66%) reported THN access. In the multivariable model, decreased THN access was associated with the fear that a person may become aggressive after being revived with THN (aOR: 0.55, 95% CI: 0.35–0.85), police threaten people at an overdose event (aOR: 0.68, 95% CI: 0.36–1.00), and insufficient overdose training (aOR: 0.43, 95% CI: 0.28–0.68). Enrollment in medication-assisted treatment, personally experiencing an overdose, and graduating from high school were associated with higher access. About half (49%) of PWUO with THN access and who had witnessed an overdose reported having administered THN. THN use was positively associated with “often” or “always” carrying THN (aOR: 3.47, 95% CI: 1.99–6.06), witnessing more overdoses (aOR:5.18, 95% CI: 2.22–12.07), experiencing recent homelessness, and injecting in the past year. THN use was reduced among participants who did not feel that they had sufficient overdose training (aOR: 0.56, 95% CI: 0.32–0.96). Conclusion THN programs must bolster confidence in administering THN and address barriers to use, such as fear of a THN recipient becoming aggressive. Normative change around carrying THN is an important component in an overdose prevention strategy.

UR - http://www.scopus.com/inward/record.url?scp=85074696772&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074696772&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0224686

DO - 10.1371/journal.pone.0224686

M3 - Article

C2 - 31697736

AN - SCOPUS:85074696772

VL - 14

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 11

M1 - e0224686

ER -