High uptake of naloxone-based overdose prevention training among previously incarcerated syringe-exchange program participants. (1st September 2015)

• Record Type: Journal Article
• Authors: Barocas, Joshua A.; Baker, Lisa; Hull, Shawnika J.; Stokes, Scott; Westergaard, Ryan P.
• Is Part Of: Drug and alcohol dependence. Volume 154(2015)
• Page Start: 283
• Page End: 286
• Publication Date: 2015-09-01
• Subjects: People who inject drugs -- Overdose -- Risky health behaviors -- Take-home naloxone -- Correctional facilities; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2015.06.023
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Forty-three percent of 543 respondents who reported injecting drugs in the prior 30 days also reported prior incarceration. Those who experienced an overdose or witnessed an overdose were more likely to report incarceration. Those who had been trained to administer naloxone were more likely to report overdose. Abstract: Background: Incarceration is common among people who inject drugs. Prior research has shown that incarceration is a marker of elevated risk for opioid overdose, suggesting that the criminal justice system may be an important, under-utilized venue for implementing overdose prevention strategies. To better understand the feasibility and acceptability of such strategies, we evaluated the utilization of naloxone-based overdose prevention training among people who inject drugs with and without a history of incarceration. Methods: We surveyed clients who utilize a multi-site syringe exchange program (SEP) in 2 cities in the Midwestern United States. Participants completed an 88-item, computerized survey assessing history of incarceration, consequences associated with injection, injecting practices, and uptake of harm reduction strategies. Results: Among 543 respondents who injected drugs in the prior 30 days, 243 (43%) reported prior incarceration. Comparing those with and without a history of incarceration, there were no significant differences with respect to age, gender, or race. Those who observed an overdose, experienced overdose, and received training to administer or have administered naloxone were more likely to report incarceration. Overall, 69% of previously incarcerated clients had been trained to administer naloxone. Conclusion: People who inject drugs with a history of incarceration appear to have a higher risk of opioid overdose than those never incarcerated, and are more willing to utilize naloxone as an overdose prevention strategy. Naloxone training and distribution is an important component of comprehensive prevention services for persons with opioid use disorders. Expansion of services for persons leaving correctional facilities should be considered.