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. 2019 Nov 1:204:107581.
doi: 10.1016/j.drugalcdep.2019.107581. Epub 2019 Sep 21.

Take-home naloxone possession among people who inject drugs in rural West Virginia

Sean T Allen  1 , Rebecca Hamilton White  2 , Allison O'Rourke  3 , Suzanne M Grieb  4 , Michael E Kilkenny  5 , Susan G Sherman  6
Affiliations

Take-home naloxone possession among people who inject drugs in rural West Virginia

Sean T Allen et al. Drug Alcohol Depend. .

Abstract

Background: Take-home naloxone (THN) possession among people who inject drugs (PWID) in rural communities is understudied. Better understanding the nature of THN possession among rural PWID could inform the implementation of overdose prevention initiatives. The purpose of this research is to determine factors associated with rural PWID having recently received THN.

Methods: Data from a PWID population estimation study implemented in Cabell County, West Virginia were used for this research. Multivariable Poisson regression with a robust variance estimator was used to evaluate the independent effects of several measures (e.g., sociodemographics, structural vulnerabilities, substance use) on PWID having received THN in the past 6 months.

Results: Forty-eight percent of our sample (n = 371) of PWID reported having received THN in the past 6 months. Factors associated with having received THN were: age (adjusted Prevalence Ratio [aPR] = 1.02; 95% Confidence Interval [CI]: 1.01-1.03), having recently accessed sterile syringes at a needle exchange program (aPR = 1.82; 95% CI: 1.35-2.46), believing that doctors judge people who use drugs (aPR = 1.50; 95% CI: 1.07-2.12), and having witnessed at least one non-fatal overdose in the past 6 months (aPR = 1.44; 95% CI: 1.06-1.94). Greater numbers of overdose events in the past 6 months were also associated with having received THN.

Conclusions: Among rural PWID in West Virginia, slightly less than half received THN in the past 6 months. Rural communities need overdose prevention interventions that are responsive to the unique needs of rural PWID, decrease stigma, and ensure PWID have access to harm reduction services and drug treatment programs.

Keywords: Harm reduction; Injection drug use; Overdose; People who inject drugs; Rural health; Take-home naloxone.

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Conflict of interest statement

Declaration of Competing Interest

Dr. Sherman is an expert witness for plaintiffs in opioid litigation.

References

    1. Allen ST, O’Rourke A, White RH, Schneider KE, Kilkenny M, Sherman SG, 2019a. Estimating the number of people who inject drugs in a rural county in Appalachia. Am. J. Public Health 109 (3), 445–450. - PMC - PubMed
    1. Allen ST, Grieb SM, O’Rourke A, Yoder R, Planchet E, White RH, Sherman SG, 2019b. Understanding the public health consequences of suspending a rural syringe services program: a qualitative study of the experiences of people who inject drugs. Harm Reduct. J 16 (1), 33. - PMC - PubMed
    1. Allen ST, O’Rourke A, White RH, Schneider KE, Hazelett T, Kilkenny M, Sherman SG, 2019c. Applying Population Estimation Methods in Rural America. Retrieved from https://americanhealth.jhu.edu/themes/bahi_stable/assets/pdfs/Opioid_Ser.... (Accessed 27 June 2019).
    1. Allen ST, O’Rourke A, White RH, Schneider KE, Hazelett T, Kilkenny M, Sherman SG, 2019d. Rural Communities in Crisis. Retrieved from https://americanhealth.jhu.edu/RuralOpioidsCount. (Accessed 27 June 2019).
    1. American Pharmacists Association, 2015. Pharmacists Prescribe Naloxone to Prevent Overdose Deaths. Retrieved from https://www.pharmacist.com/article/pharmacists-prescribe-naloxone-preven.... (Accessed 27 June 2019).

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