Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment
Abstract Background Despite the widespread availability of naloxone, US opioid overdose rates continue to rise. The “Cascade of Care” (CoC) is a public health approach that identifies steps in achieving specific outcomes and has been used to identify gaps in naloxone carriage among individuals with...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12954-023-00745-6 |
| _version_ | 1827984801363132416 |
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| author | Zofia Kozak Daniel Ciccarone Johannes Thrul Thomas O. Cole Alexander L. Pappas Aaron D. Greenblatt Christopher Welsh Mark Yoon Donald Gann E. Erin Artigiani Eric D. Wish Annabelle M. Belcher |
| author_facet | Zofia Kozak Daniel Ciccarone Johannes Thrul Thomas O. Cole Alexander L. Pappas Aaron D. Greenblatt Christopher Welsh Mark Yoon Donald Gann E. Erin Artigiani Eric D. Wish Annabelle M. Belcher |
| author_sort | Zofia Kozak |
| collection | DOAJ |
| description | Abstract Background Despite the widespread availability of naloxone, US opioid overdose rates continue to rise. The “Cascade of Care” (CoC) is a public health approach that identifies steps in achieving specific outcomes and has been used to identify gaps in naloxone carriage among individuals with opioid use disorder (OUD). We sought to apply this framework to a treatment-seeking population with OUD that may be more inclined to engage in harm reduction behaviors. Methods Patients were recruited from an urban methadone program to complete a survey. We assessed naloxone familiarity, availability, obtainability, training, and possession, as well as naloxone carriage rates, demographics, and harm reduction behaviors. A multivariable logistic regression examined associations between naloxone carriage and individual-level factors. Results Participants (n = 97) were majority male (59%), with a mean age of 48 (SD = 12), 27% had college education or higher, 64% indicated injection drug use, and 84% reported past naloxone training. All participants endorsed familiarity with naloxone, but only 42% regularly carried naloxone. The following variables were associated with carrying naloxone: White race (aOR = 2.94, 95% CI 1.02–8.52), college education (aOR = 8.11, 95% CI 1.76–37.47), and total number of self-reported harm reduction behaviors (aOR = 1.45, 95% CI 1.00–2.11). Conclusion We found low rates of naloxone carriage among methadone-treated patients. Methadone programs provide opportunities for naloxone interventions and should target racial/ethnic minorities and individuals with lower education. The spectrum of harm reduction behaviors should be encouraged among these populations to enhance naloxone carriage. |
| first_indexed | 2024-04-09T23:04:42Z |
| format | Article |
| id | doaj.art-ee9a746d70254540b359ac23912e5186 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-09T23:04:42Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-ee9a746d70254540b359ac23912e51862023-03-22T10:48:21ZengBMCHarm Reduction Journal1477-75172023-02-012011610.1186/s12954-023-00745-6Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatmentZofia Kozak0Daniel Ciccarone1Johannes Thrul2Thomas O. Cole3Alexander L. Pappas4Aaron D. Greenblatt5Christopher Welsh6Mark Yoon7Donald Gann8E. Erin Artigiani9Eric D. Wish10Annabelle M. Belcher11Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineDepartment of Family and Community Medicine, University of California, San Francisco School of MedicineDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins UniversityDivision of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineDivision of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineDivision of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineDivision of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineDivision of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineDivision of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineCenter for Substance Abuse Research, University of MarylandCenter for Substance Abuse Research, University of MarylandDivision of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of MedicineAbstract Background Despite the widespread availability of naloxone, US opioid overdose rates continue to rise. The “Cascade of Care” (CoC) is a public health approach that identifies steps in achieving specific outcomes and has been used to identify gaps in naloxone carriage among individuals with opioid use disorder (OUD). We sought to apply this framework to a treatment-seeking population with OUD that may be more inclined to engage in harm reduction behaviors. Methods Patients were recruited from an urban methadone program to complete a survey. We assessed naloxone familiarity, availability, obtainability, training, and possession, as well as naloxone carriage rates, demographics, and harm reduction behaviors. A multivariable logistic regression examined associations between naloxone carriage and individual-level factors. Results Participants (n = 97) were majority male (59%), with a mean age of 48 (SD = 12), 27% had college education or higher, 64% indicated injection drug use, and 84% reported past naloxone training. All participants endorsed familiarity with naloxone, but only 42% regularly carried naloxone. The following variables were associated with carrying naloxone: White race (aOR = 2.94, 95% CI 1.02–8.52), college education (aOR = 8.11, 95% CI 1.76–37.47), and total number of self-reported harm reduction behaviors (aOR = 1.45, 95% CI 1.00–2.11). Conclusion We found low rates of naloxone carriage among methadone-treated patients. Methadone programs provide opportunities for naloxone interventions and should target racial/ethnic minorities and individuals with lower education. The spectrum of harm reduction behaviors should be encouraged among these populations to enhance naloxone carriage.https://doi.org/10.1186/s12954-023-00745-6Harm reductionNaloxoneMethadoneOverdose |
| spellingShingle | Zofia Kozak Daniel Ciccarone Johannes Thrul Thomas O. Cole Alexander L. Pappas Aaron D. Greenblatt Christopher Welsh Mark Yoon Donald Gann E. Erin Artigiani Eric D. Wish Annabelle M. Belcher Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment Harm Reduction Journal Harm reduction Naloxone Methadone Overdose |
| title | Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment |
| title_full | Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment |
| title_fullStr | Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment |
| title_full_unstemmed | Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment |
| title_short | Harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment |
| title_sort | harm reduction behaviors are associated with carrying naloxone among patients on methadone treatment |
| topic | Harm reduction Naloxone Methadone Overdose |
| url | https://doi.org/10.1186/s12954-023-00745-6 |
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