The role of overdose reversal training in knowing where to get naloxone: Implications for improving naloxone access among people who use drugs

Background: Naloxone distribution and training programs have been implemented to combat the opioid overdose crisis. While many individuals are trained, ongoing naloxone access is not ensured by these programs. We explored whether people who use drugs (PWUD) in Baltimore City, Maryland could identify a location where they would go to obtain naloxone and how training changed where they would be willing to access naloxone. Methods: We surveyed 574 PWUD as to whether they had heard of, been trained to use, and knew where to get naloxone. Among participants who had heard of naloxone, we tested for differences in knowing where to get naloxone by training. Results: The majority (95.3%) had heard of naloxone. Of these, 84.0% could name a location where they would access naloxone, but only 11.7% named multiple. Pharmacies (32.3%) and medical providers (excluding drug treatment providers) (22.9%) were the most commonly identified sources. Participants who had been trained to use naloxone were more likely to report that they would obtain naloxone from the needle exchange and were less likely to report they did not know where they would go to get it or that they would go to a medical provider (excluding drug treatment providers) for naloxone. Conclusions: Naloxone training was associated with participants’ ability to name a location where they would obtain naloxone. Medicalized sources of naloxone remained the most commonly reported. These sources, however, may be associated with significant barriers to access, such as cost. Trainings should provide comprehensive education about low-cost/free sources to ensure ongoing naloxone access among people who use drugs.