The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City.
Distribution
Naloxone
Opioid overdose
Journal
Drug and alcohol dependence reports
ISSN: 2772-7246
Titre abrégé: Drug Alcohol Depend Rep
Pays: Netherlands
ID NLM: 9918350383506676
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
entrez:
7
11
2022
pubmed:
8
11
2022
medline:
8
11
2022
Statut:
ppublish
Résumé
Naloxone distributed to people at risk for opioid overdose has been associated with reduced overdose death rates; however, associations of retail pharmacy-distributed naloxone with overdose mortality have not been evaluated. Our analytic cohort uses retail pharmacy claims data; three health departments' community distribution data; federal opioid overdose data; and American Community Survey data. Data were analyzed by 3-digit ZIP Code and calendar quarter-year (2016Q1-2018Q4), and weighted by population. We regressed opioid-related overdose mortality on retail-pharmacy and community naloxone distribution, and community-level demographics using a linear model, hypothesizing that areas with high overdose rates would have higher current levels of naloxone distribution but that increasing naloxone distribution from one quarter to the next would be associated with lower overdose. From Q1-2016 to Q4-2018, the unadjusted naloxone distribution rate increased from 97 to 257 kits per 100,000 persons, while the unadjusted opioid overdose mortality rate fell from 8.1 to 7.2 per 100,000 persons. The concurrent level of naloxone distribution (both pharmacy and community) was positively and significantly associated with fatal opioid overdose rates. We did not detect associations between change in naloxone distribution rates and overdose mortality. Naloxone distribution volumes were correlated with fatal opioid overdose, suggesting medication was getting to communities where it was needed most. Amid high rates of overdose driven by fentanyl in the drug supply, our findings suggest additional prevention, treatment, and harm reduction interventions are required-and dramatically higher naloxone volumes needed-to reverse the opioid overdose crisis in the US.
Sections du résumé
Background
UNASSIGNED
Naloxone distributed to people at risk for opioid overdose has been associated with reduced overdose death rates; however, associations of retail pharmacy-distributed naloxone with overdose mortality have not been evaluated.
Methods
UNASSIGNED
Our analytic cohort uses retail pharmacy claims data; three health departments' community distribution data; federal opioid overdose data; and American Community Survey data. Data were analyzed by 3-digit ZIP Code and calendar quarter-year (2016Q1-2018Q4), and weighted by population. We regressed opioid-related overdose mortality on retail-pharmacy and community naloxone distribution, and community-level demographics using a linear model, hypothesizing that areas with high overdose rates would have higher current levels of naloxone distribution but that increasing naloxone distribution from one quarter to the next would be associated with lower overdose.
Results
UNASSIGNED
From Q1-2016 to Q4-2018, the unadjusted naloxone distribution rate increased from 97 to 257 kits per 100,000 persons, while the unadjusted opioid overdose mortality rate fell from 8.1 to 7.2 per 100,000 persons. The concurrent level of naloxone distribution (both pharmacy and community) was positively and significantly associated with fatal opioid overdose rates. We did not detect associations between change in naloxone distribution rates and overdose mortality.
Conclusion
UNASSIGNED
Naloxone distribution volumes were correlated with fatal opioid overdose, suggesting medication was getting to communities where it was needed most. Amid high rates of overdose driven by fentanyl in the drug supply, our findings suggest additional prevention, treatment, and harm reduction interventions are required-and dramatically higher naloxone volumes needed-to reverse the opioid overdose crisis in the US.
Identifiants
pubmed: 36337350
doi: 10.1016/j.dadr.2022.100083
pmc: PMC9631422
mid: NIHMS1835356
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : NIDA NIH HHS
ID : R01 DA046527
Pays : United States
Organisme : NIDA NIH HHS
ID : P30 DA040500
Pays : United States
Organisme : NIGMS NIH HHS
ID : P20 GM125507
Pays : United States
Organisme : NCIPC CDC HHS
ID : R01 CE002999
Pays : United States
Organisme : NIDA NIH HHS
ID : U01 DA047408
Pays : United States
Déclaration de conflit d'intérêts
Declaration of Competing Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ✰All authors report no conflict of interest.
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