The proportion of NESI participants who reported that they had been prescribed naloxone within the last year increased significantly from 8% in 2011–12 to 32% in 2013–14. In contrast, the proportion of NESI participants who carried naloxone with them on the day they were interviewed decreased significantly from 16% in 2011–12 to 5% in 2013–14.
With 2 years of Scotland's National Naloxone Programme to follow, the current data suggest at least 20% and best estimate of 36% reduction in prison release ORDs, which may be due directly to the programme. Scotland's 3-year results may encourage other nations to adopt naloxone policies. Implementation of national naloxone programmes should be monitored closely and results put into the public domain to facilitate evidence synthesis.
The National Records of Scotland (NRS) have just released the annual Drug-Related Deaths report for 2014.
The report provides statistics of drug-related deaths in 2014 and earlier years, broken down by age, sex, selected drugs reported, underlying cause of death and NHS Board and Council areas.The report states that there were 613 drug-related deaths were registered in Scotland.
Since 2008, HRC has maintained a database of organizations providing naloxone kits to laypersons. The Opioid Safety and Naloxone Network is a national network of naloxone experts, program administrators, and advocates. Before the survey, HRC staff polled network participants for information on any new organizations providing naloxone kits to laypersons that should be included in the survey. In July 2014, HRC e-mailed a link to an online survey to managers of 140 organizations known to provide naloxone kits to laypersons. These organizations included public health departments, pharmacies, health care facilities, substance use treatment facilities, and community-based organizations providing services to persons who use drugs, including current or former opioid (heroin or pharmaceutical) users, and other potential witnesses to overdoses. Law enforcement organizations, emergency medical services, and other professional first responders using naloxone were not included in this survey.
The objective of this review was to assess the effectiveness of bystander naloxone administration and overdose education programs by synthesizing quantitative results reported in the research literature. Studies meeting predefined criteria were identified and reviewed, and their results were synthesized through meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for overdose recoveries for individuals who received naloxone dispensed by non-medical community members, and the standardized mean difference was calculated for test scores of non-medical volunteers who received training in overdose management versus the scores of untrained volunteers. Pooled data from four studies showed that naloxone administration by bystanders was associated with a significantly increased odds of recovery compared with no naloxone administration (OR = 8.58, 95% CI = 3.90 to 13.25). Data from five studies of overdose education indicated that average scores were significantly higher for trained participants than untrained participants for tests on naloxone administration, overdose recognition, and overdose response (standardized mean difference = 1.35, 95% CI = 0.92 to 1.77). Empirical evidence in the research literature suggests that bystander naloxone administration and overdose education programs are associated with increased odds of recovery and with improved knowledge of overdose recognition and management in non-clinical settings.
The National Forum on Drug-Related Deaths releases Annual Report containing recommendations for 2014 and Scottish Government responses to the Forum 2013 recommendations.
This is the fifth report from the National Drug-Related Deaths Database (NDRDD) for Scotland which presents data for the calendar year 2013 and trend data back to 2009. The NDRDD was established to collect detailed information regarding the nature, health and social circumstances of individuals who have died a drug-related death. This report analyses a specific cohort of drug-related deaths in Scotland on which National Statistics have already been published by National Records of Scotland (NRS).
Allowing more basic emergency medical service (EMS) staff to administer naloxone could reduce drug overdose deaths that involve opioids, according to a Centers for Disease Control and Prevention (CDC) study, “Disparity in Naloxone Administration by Emergency Medical Service Providers and the Burden of Drug Overdose in Rural Communities,” published in the American Journal of Public Health.
Aims: Scotland was the first country to adopt take-home naloxone (THN) as a funded public health policy. We summarise the background and rigorous set-up for before/after monitoring to assess the impact on high-risk opiate-fatalities. Methods: Evidence-synthesis of prospectively monitored small-scale THN schemes led to a performance indicator for distribution of THN-kits relative to opiate-related deaths. Next, we explain the primary outcome and statistical power for Scotland’s before/after monitoring. Results: Fatality-rate at opiate overdoses witnessed by THN-trainees was 6% (9/153, 95% CI: 2–11%). National THN-schemes should aim to issue 20 times as many THN-kits as there are opiate-related deaths per annum; and at least nine times as many. Primary outcome for evaluating Scotland’s THN policy is reduction in the percentage of all opiate-related deaths with prison-release as a 4-week antecedent. Scotland’s baseline period is 2006–10, giving a denominator of 1970 opiate-related deaths. A priori plausible effectiveness was 20–30% reduction, relative to baseline, in the proportion of opiate-related deaths that had prison-release as a 4-week antecedent. A secondary outcome was also defined. Conclusion: If Scotland’s THN evaluation shifts the policy ground seismically, our new performance measure may prove useful on how many THN-kits nations should provide annually.