Knowledge and Diffusion of Take-Home Naloxone Among People who use Opioids in France

Author: Salim Mezaache Clemence Lacroix Franck Turlure Joelle Micallef Elisabeth Frauger

Theme: Epidemiology & Public Health Research Year: 2022

Opioid use can lead to life-threatening overdoses, in particular among people with opioid use
disorders. Since 2016, opioid-specific antidote naloxone is available in France through take-home kits
that can be administered by any overdose witness. Our aim was to assess knowledge of naloxone
among opioid users and its diffusion.
We performed two analyses: we first used data from the 2020 OPPIDUM survey that enrolled during
a month drug users visiting specialized addiction and harm reduction (HR) centres in France. These
centres provide free naloxone to users and relatives. Participants were asked for knowledge, carrying
and use of naloxone. Correlates of knowledge were assessed using logistic regression; secondly we
conducted semi-structured interviews within a sample of professionals from specialized addiction and
HR centres. We explored practices, barriers and needs regarding naloxone diffusion.
Of the 3599 opioid users in the OPPIDUM survey, 45.6% known about naloxone availability, 19.3%
were carrying a kit and 2.4% used it for them or a relative. Multivariable logistic analysis showed older
respondents(Odds Ratio (OR)=0.98 [95%CI=0.98-0.99]) and women (OR=0.79 [95%CI=0.66-0.95]) were
less aware of naloxone. Conversely, higher education (OR=1.81 [95%CI=1.16-2.82]), polydrug use
(OR=1.16 [95%CI=1.08-1.25]) and intravenous drug use (OR=2.86 [95%CI=2.15-3.80]) were associated
with naloxone knowledge. Compared to buprenorphine-based opioid agonist treatment recipients,
those receiving methadone (OR=2.68 [95%CI=1.96-3.67]) were more aware of naloxone. Of the 33
centres interviewed, 22 were supplying naloxone with a mean of 20 (min-max: 1-100) kits per centre
distributed in 2020. Some centres offer naloxone to all opioid users whereas other target at-risk
individuals. Major barriers to naloxone diffusion included users disinterest or refusal, regulatory or
time constraints and lack of professional training.
Knowledge and diffusion of naloxone is still limited among French opioid users. Our results will inform
future developments of interventions towards professionals and opioid users to expand naloxone
Disclosure of Interest Statement
All authors declare no competing interests.

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