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Naloxone protection, social support, network characteristics, and overdose experiences among a cohort of people who use illicit opioids in New York City
Journal article   Open access   Peer reviewed

Naloxone protection, social support, network characteristics, and overdose experiences among a cohort of people who use illicit opioids in New York City

Alex S Bennett, Joy Scheidell, Jeanette M Bowles, Maria Khan, Alexis Roth, Lee Hoff, Christina Marini and Luther Elliott
Harm reduction journal, v 19(1), pp 20-20
04 Mar 2022
DOI: https://doi.org/10.1186/s12954-022-00604-w
PMID: 35246165
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1186/s12954-022-00604-wView
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

Adult Analgesics, Opioid - therapeutic use Drug Overdose - drug therapy Humans Middle Aged Naloxone - therapeutic use Narcotic Antagonists - therapeutic use New York City - epidemiology Opioid-Related Disorders - drug therapy Public Policy Social Networking Social Support
Despite increased availability of take-home naloxone, many people who use opioids do so in unprotected contexts, with no other person who might administer naloxone present, increasing the likelihood that an overdose will result in death. Thus, there is a social nature to being "protected" from overdose mortality, which highlights the importance of identifying background factors that promote access to protective social networks among people who use opioids. We used respondent-driven sampling to recruit adults residing in New York City who reported recent (past 3-day) nonmedical opioid use (n = 575). Participants completed a baseline assessment that included past 30-day measures of substance use, overdose experiences, and number of "protected" opioid use events, defined as involving naloxone and the presence of another person who could administer it, as well as measures of network characteristics and social support. We used modified Poisson regression with robust variance to estimate unadjusted and adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs). 66% of participants had ever been trained to administer naloxone, 18% had used it in the past three months, and 32% had experienced a recent overdose (past 30 days). During recent opioid use events, 64% reported never having naloxone and a person to administer present. This was more common among those: aged ≥ 50 years (PR: 1.18 (CI 1.03, 1.34); who identified as non-Hispanic Black (PR: 1.27 (CI 1.05, 1.53); experienced higher levels of stigma consciousness (PR: 1.13 (CI 1.00, 1.28); and with small social networks (< 5 persons) (APR: 1.14 (CI 0.98, 1.31). Having a recent overdose experience was associated with severe opioid use disorder (PR: 2.45 (CI 1.49, 4.04), suicidality (PR: 1.72 (CI 1.19, 2.49), depression (PR: 1.54 (CI 1.20, 1.98) and positive urinalysis result for benzodiazepines (PR: 1.56 (CI 1.23, 1.96), but not with network size. Results show considerable gaps in naloxone protection among people who use opioids, with more vulnerable and historically disadvantaged subpopulations less likely to be protected. Larger social networks of people who use opioids may be an important resource to curtail overdose mortality, but more effort is needed to harness the protective aspects of social networks.

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24 citations in Web of Science
20 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Substance Abuse
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