Home > Effectiveness of Scotland's national naloxone programme for reducing opioid-related deaths: a before (2006-10) versus after (2011-13) comparison.

Bird, Sheila M and McAuley, Andrew and Perry, Samantha and Hunter, Carole (2016) Effectiveness of Scotland's national naloxone programme for reducing opioid-related deaths: a before (2006-10) versus after (2011-13) comparison. Addiction , 111 , (5) , pp. 883-891.

URL: http://onlinelibrary.wiley.com/doi/10.1111/add.132...

AIMS: To assess the effectiveness for Scotland's National Naloxone Programme (NNP) by comparison between 2006-10 (before) and 2011-13 (after NNP started in January 2011) and to assess cost-effectiveness.

DESIGN: This was a pre-post evaluation of a national policy. Cost-effectiveness was assessed by prescription costs against life-years gained per opioid-related death (ORD) averted. The setting was Scotland, in community settings and all prisons.

INTERVENTION: Brief training and standardized naloxone supply became available to individuals at risk of opioid overdose.

MEASUREMENTS: ORDs as identified by National Records of Scotland. Look-back determined the proportion of ORDs who, in the 4 weeks before ORD, had been i) released from prison (primary outcome), ii) released from prison or discharged from hospital (secondary). We report 95% confidence intervals for effectiveness in reducing the primary (and secondary) outcome in 2011-13 versus 2006-10. Prescription costs were assessed against 1 or 10 life-years gained per averted ORD.

FINDINGS: In 2006-2010, 9.8% of ORDs (193/1970) were in people released from prison within 4 weeks of death whereas only 6.3% of ORDs in 2011-2013 followed prison release (76/1212, p <0.001; this represented a reduction of 3.6%). This reduction in the proportion of prison release ORDs translates into 42 fewer prison release ORDs during 2011-13, when 12,000 naloxone kits were issued at current prescription-cost of £225,000. Scotland's secondary outcome reduced from 19.0% to 14.9%, a reduction of 4.1%.

CONCLUSIONS: Scotland's National Naloxone Programme, which started in 2011, was associated with a 36% reduction in the proportion of opioid-related deaths that occurred in the 4 weeks following release from prison. [This article is protected by copyright. All rights reserved.]

Item Type:Article
Date:7 December 2016
Page Range:pp. 883-891
Subjects:B Substances > Opioids (opiates)
B Substances > Opioids (opiates) > Opioid product > Naloxone
G Health and disease > Substance use disorder > Drug use > Drug intoxication > Poisoning (overdose)
L Social psychology and related concepts > Life event > Change or event related to family or friend > Death of family member or close friend
MM-MO Crime and law > Criminal penalty > Community service (penalty) > Probation or parole
MP-MR Policy, planning, economics, work and social services > Policy > Policy on substance use > Harm reduction policy
P Demography, epidemiology, and history > Population dynamics > Substance related mortality / death
T Demographic characteristics > Prison Inmate (prisoner)
T Demographic characteristics > Offender
VA Geographic area > Europe > United Kingdom > Scotland

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