Opportunities to boost naloxone awareness among people who misuse opioid analgesics who have not used illegal opioids

Abstract

Background

Increasing naloxone awareness and carrying among individuals who misuse opioid analgesic medications (OAs) could reduce opioid overdose mortality. Methods: Self-report surveys were completed by 322 adults receiving residential addiction treatment who misused OAs in the past year. Descriptive analyses and prevalence ratios (using Poisson generalized estimating equations) examined whether illegal opioid (e.g., heroin) initiation was associated with naloxone awareness. Results: Among this sample of participants who misused OAs, naloxone awareness was lowest among those who never used illegal opioids (26%) and highest among those who transitioned from OAs to illegal opioid use over time (83%). Naloxone awareness remained higher among participants who had used illegal opioids after adjustment for sociodemographic and substance use characteristics. Those who used OAs before initiating illegal opioids were 2.3-fold (95% CI: 1.5–3.3) more likely to have naloxone awareness than those who had only misused OAs after adjustment. Half of participants who had only used OAs had experienced an overdose, 75% had witnessed an overdose, and 61% were prescribed OAs to treat pain in the past 6 months. Conclusions: Implementing overdose education and naloxone distribution programs during addiction treatment could bolster naloxone awareness among people who misuse OAs but who have not used illegal opioids.

Keywords:

• Naloxone
• opioids
• heroin
• overdose
• harm reduction
• addiction treatment services

Acknowledgements

The authors thank Emily Yeagley and Laura Thomas for providing project oversight, Mary Jannausch for collating data, and the participants and staff at the addiction treatment facility who facilitated this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

ASBB designed and conducted the parent study and acquired funding. All authors conceptualized the analysis. REG conducted the analysis and wrote the first draft under the supervision of ACF. All authors reviewed, edited, and approved the final manuscript.

Data availability statement

The data that support the findings of this study are available from the corresponding author, REG, upon reasonable request.

Additional information

Funding

This work was supported by National Institute on Drug Abuse Grant R34-DA035331, National Institute of Allergy and Infectious Diseases Grant T32-AI102623, and National Institute on Alcohol Abuse and Alcoholism Grant K23-AA023869. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.