Regional Broad Scale Implementation of Take Home Naloxon in Sweden, 42 Months Follow Up – Small Group Manages Large Proportion of Opioid Overdoses

Author: Katja Troberg Pernilla Isendahl Marianne Alanko Blomé

Theme: Models of Care Year: 2022

Sweden has the highest proportion of drug related deaths in EU. Broad scale overdose prevention
and naloxone distribution is one of the important cornerstones in reducing mortality and morbidity.
Skåne County implemented a multi-site naloxone program at 37 units including all needle exchange
services and addiction facilities including all OSTs in the region.
Description of model of care/intervention:
During the first 42 months of the program 2097 individuals received training and an initial takehome naloxone kit. In accordance with Swedish law, naloxone can only be prescribed to a person at
risk of opioid overdose. Naloxone was received at the end of brief training-session, free of charge.
Upon patients return for naloxone refill staff asked what had happened to the previous dose(s).
Program coordinators collected data from key representatives at each of the included units every six
months during June 2018-December 2021.

During the 42-months of follow-up, a total number of 3898 naloxone kits had been
distributed, each kit containing 2 doses of intranasal naloxone. Naloxone was reportedly used in 599
occasions to reverse opioid overdose, of which 553 naloxone had been used on someone else than
the prescription recipient. A small group of naloxone administrators managed a significant number
of overdoses. The 2% (n=49) individuals who reported overdose reversals on three occasions or
more, had a mean age of 38 years, 40% were women and reported 43% (n=236) reversals on others.
Conclusion and next steps:
This core group contains naloxone administrators whose actions are vital to the community, the
program, and their peers. To provide support and to create and maintain sustainable conditions in
which peers will continue to carry this social responsibility it is imperative to study needs and
experiences on overdose management within this group.
Disclosure of Interest Statement:

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