1. Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study.
- Author
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Moustaqim-Barrette A, Papamihali K, Williams S, Ferguson M, Moe J, Purssell R, and Buxton JA
- Subjects
- Adolescent, Adult, British Columbia epidemiology, Female, Humans, Male, Middle Aged, Young Adult, Naloxone adverse effects, Narcotic Antagonists adverse effects, Opiate Overdose drug therapy, Opioid-Related Disorders drug therapy, Substance Withdrawal Syndrome drug therapy
- Abstract
Introduction: Take-Home Naloxone programs have been introduced across North America in response to rising opioid overdose deaths. There is currently limited real-world data on bystander naloxone administration, overdose outcomes, and evidence related to adverse events following bystander naloxone administration., Methods: The research team used descriptive statistics from Take-Home Naloxone administration forms. We explored reported demographic variables and adverse events among people who received by-stander administered naloxone in a suspected opioid overdose event between August 31, 2012 and December 31, 2018 in British Columbia. We examined and contextualized differences across years given policy, program and drug toxicity changes. We used multivariate logistic regression to examine whether an association exists between number of ampoules of naloxone administered and the odds that the recipient will experience withdrawal symptoms., Results: A large majority (98.1%) of individuals who were administered naloxone survived their overdose and 69.2% had no or only mild withdrawal symptoms. Receiving three (Adjusted Odds Ratio (AOR) 1.64 (95% Confidence Interval (CI): 1.08-2.48)) or four or more (AOR 2.19 (95% CI: 1.32-3.62)) ampoules of naloxone was significantly associated with odds of moderate or severe withdrawal compared to receiving one ampoule of naloxone., Conclusions: This study provides evidence from thousands of bystander reversed opioid overdoses using Take-Home Naloxone kits in British Columbia, and suggests bystander-administered naloxone is safe and effective for opioid overdose reversal. Data suggests an emphasis on titration during bystander naloxone training in situations where the person experiencing overdose can be adequately ventilated may help avoid severe withdrawal symptoms. We identified a decreasing trend in the likelihood of moderate or severe withdrawal over the study period., Competing Interests: Authors KP, SW and JB work for the BC Centre of Disease Control (BCCDC) an agency of the Provincial Health Services Authority; BCCDC is responsible for administering the BC take-home naloxone program which is funded by the BC Ministry of Health. The BC MoH had no input into the methods, analysis or writing of this manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
- Published
- 2021
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