Knowledge and possession of take-home naloxone kits among street-involved youth in a Canadian setting: a cohort study

Julia Goldman-Hasbun,Ekaterina Nosova,Kora DeBeck,Thomas Kerr,Evan Wood,Jane A. Buxton

doi:10.1186/s12954-017-0206-6

Abstract

BackgroundThe distribution of take-home naloxone (THN) kits has been an important strategy in reducing overdose fatalities among people who use drugs. However, little is known about the use of THN among youth who are street-involved. The present study explores knowledge and possession of THN among street-involved youth in a Canadian setting.MethodsData were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth age 14–28 at enrollment in Vancouver, Canada. Participants completed a standardized questionnaire, which included items related to knowledge and possession of THN, sociodemographic characteristics, and substance use-related factors. Multivariable logistic regression models were used to identify factors independently associated with knowledge and possession of THN.ResultsBetween December 2014 and November 2016, 177 youth were interviewed, including 68 females (38.4%). While 126 (71.2%) participants reported knowledge of THN, only 40 (22.6%) possessed a THN kit. Caucasian/white ethnicity was found to be positively associated with both knowledge and possession of THN (both p < 0.05). Public injection drug use in the last 6 months was found to be positively associated with knowledge of THN, while daily heroin use and daily methamphetamine use were associated with possession of THN (all p < 0.05). Male gender was negatively associated with possession of THN (p < 0.05).ConclusionsThese findings highlight important gaps between knowledge and possession of THN among youth and the need to increase participation in THN programs among specific populations including non-white and male youth. Further research is needed to gain a better understanding of the barriers that may prevent certain youth from acquiring THN kits.

Highlights

The distribution of take-home naloxone (THN) kits has been an important strategy in reducing overdose fatalities among people who use drugs
Public injection drug use was independently positively associated with THN knowledge, while daily cocaine or crack use was independently negatively associated with THN knowledge
There is evidence that people who use drugs (PWUD) are likely to underestimate their own risk of opioid overdose [23], which has been identified as a major barrier to THN ownership among adult PWUD [22]

Summary

Introduction

The distribution of take-home naloxone (THN) kits has been an important strategy in reducing overdose fatalities among people who use drugs. Take-home naloxone (THN) programs, such as B.C.’s Take Home Naloxone program [4] and the Overdose Education and Nasal Naloxone Distribution program (OEND) in Massachusetts [5], have been important strategies in reducing overdose deaths among persons who use drugs. Naloxone distribution programs provide participants with naloxone in a packaged kit and provide training on how to recognize and respond to an opioid-related overdose, including administration of naloxone [6]. A recent systematic review suggested that THN programs are effective in reducing overdose mortality rates in program participants and in the community [8], with little risk involved in its administration [9]. There is evidence that younger people who use drugs (PWUD) are less likely to access harm reduction services than older PWUD [10,11,12], which raises concerns about the uptake of THN among youth

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