Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada
Introduction Implementing public health vending machines (PHVMs) is an evidence-based strategy for mitigating substance use-associated morbidity and mortality via the dispensation of essential supplies to people who use drugs, including overdose prevention resources. PHVMs have been implemented thro...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2022.2121418 |
| _version_ | 1818032055519281152 |
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| author | Sean T. Allen Allison O’Rourke Jessica. A. Johnson Chelsi Cheatom Ying Zhang Brandon Delise Kellie Watkins Kathleen Reich Rick Reich Cassius Lockett |
| author_facet | Sean T. Allen Allison O’Rourke Jessica. A. Johnson Chelsi Cheatom Ying Zhang Brandon Delise Kellie Watkins Kathleen Reich Rick Reich Cassius Lockett |
| author_sort | Sean T. Allen |
| collection | DOAJ |
| description | Introduction Implementing public health vending machines (PHVMs) is an evidence-based strategy for mitigating substance use-associated morbidity and mortality via the dispensation of essential supplies to people who use drugs, including overdose prevention resources. PHVMs have been implemented throughout the world; however, their implementation in the United States (US) is a recent phenomenon. In 2017, Trac-B Exchange (a syringe services program in Clark County, Nevada) installed three PHVMs. In 2019, naloxone dispensation was launched at PHVMs in Clark County. The purpose of this research is to examine the extent to which naloxone dispensation at PHVMs was associated with changes in opioid-involved overdose fatalities.Methods Monthly counts of opioid-involved overdose fatalities among Clark County residents that occurred from January 2015 to December 2020 were used to build an autoregressive integrated moving averages (ARIMA) model to measure the impact of naloxone dispensation at PHVMs. We forecasted the number of expected opioid-involved overdose fatalities had naloxone dispensation at PHVMs not occurred and compared to observed monthly counts. Interrupted time series analyses (ITSA) were used to evaluate the step (i.e. the immediate impact of naloxone dispensation at PHVMs on opioid-involved overdose fatalities) and slope change (i.e. changes in trend and directionality of monthly counts of opioid-involved overdose fatalities following naloxone dispensation at PHVMs).Results During the 12-months immediately following naloxone dispensation at PHVMs, our model forecasted 270 opioid-involved overdose fatalities, but death certificate data indicated only 229 occurred, suggesting an aversion of 41 deaths. ITSA identified a significant negative step change in opioid-involved overdose fatalities at the time naloxone dispensation at PHVMs was launched (B = −8.52, p = .0022) and a significant increasing slope change (B = 1.01, p<.0001). Forecasts that extended into the COVID-19 pandemic suggested worsening trends in overdose fatalities.Conclusion Naloxone dispensation at PHVMs was associated with immediate reductions in opioid-involved overdose fatalities. Key MessagesNaloxone dispensation at PHVMs was associated with immediate reductions in opioid-involved overdose fatalities.Communities should consider implementing public health vending machines in efforts to prevent opioid-involved overdose fatalities.The COVID-19 pandemic worsened the overdose crisis. |
| first_indexed | 2024-12-10T06:01:17Z |
| format | Article |
| id | doaj.art-0b5df019551c44348a1b43799b366bac |
| institution | Directory Open Access Journal |
| issn | 0785-3890 1365-2060 |
| language | English |
| last_indexed | 2024-12-10T06:01:17Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj.art-0b5df019551c44348a1b43799b366bac2022-12-22T01:59:48ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602022-12-015412692270010.1080/07853890.2022.2121418Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, NevadaSean T. Allen0Allison O’Rourke1Jessica. A. Johnson2Chelsi Cheatom3Ying Zhang4Brandon Delise5Kellie Watkins6Kathleen Reich7Rick Reich8Cassius Lockett9Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USADC Center for AIDS Research, Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USASouthern Nevada Health District, Las Vegas, NV, USATrac-B Exchange, Las Vegas, NV, USASouthern Nevada Health District, Las Vegas, NV, USASouthern Nevada Health District, Las Vegas, NV, USASouthern Nevada Health District, Las Vegas, NV, USATrac-B Exchange, Las Vegas, NV, USATrac-B Exchange, Las Vegas, NV, USASouthern Nevada Health District, Las Vegas, NV, USAIntroduction Implementing public health vending machines (PHVMs) is an evidence-based strategy for mitigating substance use-associated morbidity and mortality via the dispensation of essential supplies to people who use drugs, including overdose prevention resources. PHVMs have been implemented throughout the world; however, their implementation in the United States (US) is a recent phenomenon. In 2017, Trac-B Exchange (a syringe services program in Clark County, Nevada) installed three PHVMs. In 2019, naloxone dispensation was launched at PHVMs in Clark County. The purpose of this research is to examine the extent to which naloxone dispensation at PHVMs was associated with changes in opioid-involved overdose fatalities.Methods Monthly counts of opioid-involved overdose fatalities among Clark County residents that occurred from January 2015 to December 2020 were used to build an autoregressive integrated moving averages (ARIMA) model to measure the impact of naloxone dispensation at PHVMs. We forecasted the number of expected opioid-involved overdose fatalities had naloxone dispensation at PHVMs not occurred and compared to observed monthly counts. Interrupted time series analyses (ITSA) were used to evaluate the step (i.e. the immediate impact of naloxone dispensation at PHVMs on opioid-involved overdose fatalities) and slope change (i.e. changes in trend and directionality of monthly counts of opioid-involved overdose fatalities following naloxone dispensation at PHVMs).Results During the 12-months immediately following naloxone dispensation at PHVMs, our model forecasted 270 opioid-involved overdose fatalities, but death certificate data indicated only 229 occurred, suggesting an aversion of 41 deaths. ITSA identified a significant negative step change in opioid-involved overdose fatalities at the time naloxone dispensation at PHVMs was launched (B = −8.52, p = .0022) and a significant increasing slope change (B = 1.01, p<.0001). Forecasts that extended into the COVID-19 pandemic suggested worsening trends in overdose fatalities.Conclusion Naloxone dispensation at PHVMs was associated with immediate reductions in opioid-involved overdose fatalities. Key MessagesNaloxone dispensation at PHVMs was associated with immediate reductions in opioid-involved overdose fatalities.Communities should consider implementing public health vending machines in efforts to prevent opioid-involved overdose fatalities.The COVID-19 pandemic worsened the overdose crisis.https://www.tandfonline.com/doi/10.1080/07853890.2022.2121418Public health vending machinesharm reduction vending machinesoverdose fatalitiesnaloxone |
| spellingShingle | Sean T. Allen Allison O’Rourke Jessica. A. Johnson Chelsi Cheatom Ying Zhang Brandon Delise Kellie Watkins Kathleen Reich Rick Reich Cassius Lockett Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada Annals of Medicine Public health vending machines harm reduction vending machines overdose fatalities naloxone |
| title | Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada |
| title_full | Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada |
| title_fullStr | Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada |
| title_full_unstemmed | Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada |
| title_short | Evaluating the impact of naloxone dispensation at public health vending machines in Clark County, Nevada |
| title_sort | evaluating the impact of naloxone dispensation at public health vending machines in clark county nevada |
| topic | Public health vending machines harm reduction vending machines overdose fatalities naloxone |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2022.2121418 |
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