High uptake of naloxone-based overdose prevention training among previously incarcerated syringe-exchange program participants

TY - JOUR

T1 - High uptake of naloxone-based overdose prevention training among previously incarcerated syringe-exchange program participants

AU - Barocas, Joshua A.

AU - Baker, Lisa

AU - Hull, Shawnika J.

AU - Stokes, Scott

AU - Westergaard, Ryan P.

N1 - Publisher Copyright: © 2015 Elsevier Ireland Ltd.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - 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.

AB - 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.

KW - Correctional facilities

KW - Overdose

KW - People who inject drugs

KW - Risky health behaviors

KW - Take-home naloxone

UR - http://www.scopus.com/inward/record.url?scp=84938971296&partnerID=8YFLogxK

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U2 - 10.1016/j.drugalcdep.2015.06.023

DO - 10.1016/j.drugalcdep.2015.06.023

M3 - Article

C2 - 26143300

SN - 0376-8716

VL - 154

SP - 283

EP - 286

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

ER -