The extent of and factors associated with self-reported overdose and self-reported receipt of naloxone among people who inject drugs (PWID) in England, Wales and Northern Ireland

Int J Drug Policy. 2017 Aug:46:34-40. doi: 10.1016/j.drugpo.2017.05.017. Epub 2017 Jun 3.

Abstract

Background: Overdose is a major cause of death among PWID, and for opioid overdoses naloxone administration can reduce harm. However, globally there is limited national level data on the extent of non-fatal overdose and naloxone uptake. The first national level data on the extent of self-reported overdose and self-reported receipt of naloxone among UK PWID, providing a baseline to monitor the impact of the recent policy change regarding naloxone availability, is presented.

Methods: Data on self-reported overdose and receipt of naloxone during the preceding year for 2013-2014 from a national survey of PWID was analysed. Participants who reported injecting during the preceding year were included.

Results: Participants (3850) were predominantly male (75%); mean age was 36 years. The most commonly injected drugs were: heroin (91%), crack (45%) and amphetamine (29%). 15% (591) reported overdosing during the preceding year. There were no differences in the proportion reporting overdose by age or gender, but overdose was more common among those who: injected multiple drugs; recently ceased addiction treatment; injected with used needles/syringes; ever had transactional sex; had used a sexual health clinic or emergency department and lived in Wales or Northern Ireland. Among those reporting an overdose during the preceding year, a third reported two to four overdoses and 7.5% five or more overdoses; half reported receiving naloxone. Those reporting naloxone receipt in the preceding year were more likely to: live in Wales or Northern Ireland; ever received used needles/syringes; ever been imprisoned; and less likely to have injected two drug types.

Conclusion: These data provide a baseline for monitoring the impact of the 2015 UK policy change to improve take-home naloxone access. Interventions tackling overdose should promote naloxone awareness and access, and target those who; are poly-drug injectors, have ceased treatment, share needles/syringes and whose drug use links to sexual activity.

Keywords: Harm reduction; Heroin; Naloxone; Overdose; People who inject drugs; United Kingdom.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Drug Overdose / drug therapy*
  • Drug Overdose / epidemiology
  • England / epidemiology
  • Female
  • Harm Reduction
  • Humans
  • Male
  • Naloxone / administration & dosage*
  • Narcotic Antagonists / administration & dosage
  • Needle Sharing / statistics & numerical data
  • Northern Ireland / epidemiology
  • Opioid-Related Disorders / complications*
  • Opioid-Related Disorders / epidemiology
  • Risk Factors
  • Risk-Taking
  • Self Report
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / epidemiology
  • Substance-Related Disorders / epidemiology
  • Surveys and Questionnaires
  • Wales / epidemiology

Substances

  • Narcotic Antagonists
  • Naloxone