Access and Barriers to Take-Home Naloxone Use among Emergency Department Patients with Opioid Misuse in Baltimore, Maryland, USA. (1st October 2020)

• Record Type: Journal Article
• Authors: Hurt, Brenten R.; Hussain, Atizaz; Aledhaim, Ali; Moayedi, Siamak; Schenkel, Stephen M.; Kim, Hong K.
• Is Part Of: Substance use & misuse. Volume 55:Number 13(2020)
• Page Start: 2237
• Page End: 2242
• Publication Date: 2020-10-01
• Subjects: Take-home naloxone -- naloxone access -- naloxone use -- opioid misuse -- emergency department -- barrier to access; Narcotic habit -- Periodicals; Alcoholism -- Periodicals; Substance abuse -- Periodicals; Behavior, Addictive -- Periodicals; Sustance-Related Disorders -- Periodicals; 362.2905
• DOI: 10.1080/10826084.2020.1797811
• Languages: English
• ISSNs: 1082-6084

Abstract

Abstract: Background: The opioid epidemic has prompted the expansion of take-home naloxone (THN) distribution programs. The proportion of emergency department (ED) patients with opioid misuse who have access to a naloxone kit (NK) and barriers to using it are unclear. Objective: Characterizing the access and barrier to NK use among at-risk ED patients. Methods: We enrolled a convenience sample of ED patients with active opioid misuse from May 21–July 31, 2018. We administered a survey to collect patients' demographic data, substance use history, and access to and use of NK. The primary outcome was NK access (prior receipt of a kit or prescription); secondary outcomes were knowledge and use of NK, and barriers to obtaining and using it. Results: Of 165 respondents, 71.5% knew of THN programs and 57.6% ( n = 95) had access to THN by either having received a NK ( n = 90) or a prescription ( n = 5); 34 respondents received both. Among 39 (23.6%) who received a naloxone prescription, 25 (64.1%) filled it. 60.0% ( n = 99) reported knowing how to administer naloxone; lack of training was the primary reason ( n = 63/66, 96.9%) for their unfamiliarity. Patients who presented after an opioid overdose (25.5%; n = 42) were less likely to have knowledge of THN programs (57.1% vs. 76.4%), and to have received a NK (35.7% vs. 61.0%). Conclusion: Awareness of THN programs was high among our cohort. But approximately 60% the respondents received a NK or knew how to use it. Despite efforts to expand THN access, gaps in knowledge, access, and use exist.