High levels of uptake and use of naloxone among participants in a Take-Home-Naloxone program in Stockholm, Sweden

Author: Elin Holmén Martin Kåberg

Theme: Clinical Research Year: 2021

Background: Fatal and non-fatal opioid overdoses are growing concerns worldwide, particularly among people who inject drugs (PWID). Sweden, with the highest proportion of drug related mortality in Europe, introduced Take-Home Naloxone (THN) programs in 2018. In this study, we aim to evaluate the implementation and take-up of the first THN program in Sweden, at the Stockholm needle exchange program (NEP), by investigating THN participants demographics and level of naloxone use. Methods: This was a prospective open inclusion cohort study with passive follow-up. All Stockholm NEP clients who visited the NEP between January 24th 2018 and January 23th 2020 were eligible for THN program inclusion. At inclusion, THN participants provided data regarding previous experiences of drug overdoses. Participants underwent a 10–15-minute training session and received THN, free of charge. At every naloxone refill visit, participants reported if the naloxone had been used to reverse an overdose and if so, responded to a ten-item questionnaire about the intervention, including actions taken and the outcome for the victim. Results: Overall, 36.1% of visiting NEP clients were included as THN participants (n=802) during the study period. The majority (89.4%) used opioids, mainly heroin, and had experience of previous witnessed overdoses (86.3%) or personal overdoses (71.1%). 281 (35.0%) participants reported using naloxone in a total of 634 overdoses, of which the majority (95.1%) were successfully reversed. Conclusion: The first ever THN program in Sweden achieved broad participation and acceptance in a high-risk population of PWID within an NEP. During the two-year study period, THN participants reported a high level of naloxon use and successful overdose reversals. These findings identify a previously unmet need for naloxone in a setting formerly naive to THN programs. Increasing the reach of THN in Sweden is dependent on wider implementation and changes to current legislation. Disclosure of Interest Statement: MK has received honoraria for lectures/consultancy from AbbVie, Gilead, MSD, Mundipharma, DnE Pharma and Nordic Drugs and has received research grants from Gilead and Nordic Drugs.

Download abstract Watch video