Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022;43(1):1172-1179.
doi: 10.1080/08897077.2022.2074597.

Gaps in naloxone ownership among people who inject drugs during the fentanyl wave of the opioid overdose epidemic in New York City, 2018

Alexis V Rivera  1 , Michelle L Nolan  2 , Denise Paone  2 , Sidney A Carrillo  1 , Sarah L Braunstein  1
Affiliations

Gaps in naloxone ownership among people who inject drugs during the fentanyl wave of the opioid overdose epidemic in New York City, 2018

Alexis V Rivera et al. Subst Abus. 2022.

Abstract

Background: Community distribution of naloxone, a medication that reverses opioid overdose, is an effective public health strategy to prevent overdose deaths. However, data are limited on who has naloxone during the current fentanyl wave of the opioid overdose epidemic in the United States. We aim to determine correlates of naloxone ownership among a community sample of people who inject drugs (PWID) from New York City (NYC). Methods: Data were drawn from the National HIV Behavioral Surveillance Study among PWID. Participants were recruited via respondent-driven sampling. Eligible participants completed an interviewer-administered survey. Log-linked Poisson regression was used to determine adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) current naloxone ownership. Results: Of 503 PWID, 60% currently owned naloxone. In the past 12 months, 74% witnessed an opioid overdose and 25% experienced one. Those who experienced current homelessness were less likely to own naloxone (aPR: 0.79; 95% CI: 0.68, 0.91), as were those who had been recently incarcerated (aPR: 0.83; 95% CI: 0.71, 0.97). Respondents who reported recent known or possible fentanyl use were more likely to own naloxone (aPR: 1.23; 95% CI: 1.07, 1.43) as were those who experienced an opioid overdose in the past 12 months (aPR: 1.33; 95% CI: 1.15, 1.53). Conclusions: The prevalence of naloxone ownership among PWID in NYC was high, potentially due to widespread community naloxone distribution programs; however, gaps in naloxone ownership existed. Interventions that further ease access to naloxone, such as reclassifying naloxone as an over-the-counter medication and making it available "off the shelf," should be considered. More research is needed to identify barriers to access, uptake, and sustained possession within this group to maximize the impact of naloxone distribution during the ongoing fentanyl wave of the opioid overdose epidemic.

Keywords: Naloxone; PWID; fentanyl; overdose prevention.

PubMed Disclaimer

Conflict of interest statement

Disclosure statement: The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Study recruitment and eligibility flow diagram.
Figure 2.
Figure 2.
Where respondents received naloxone in the past 12 months (n=233).1 1 Among those who reported receiving naloxone in the past 12 months (n=233); categories are not mutually exclusive.
See this image and copyright information in PMC

References

    1. Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P and Davis NL. Trends and geographic patterns in drug and synthetic opioid overdose deaths - United States, 2013–2019. MMWR Morb Mortal Wkly Rep. 2021;70(6):202–207. - PMC - PubMed
    1. Centers for Disease Control and Prevention. Rising numbers of deaths involving fentanyl and fentanyl analogs, including carfentanil, and increased usage and mixing with non-opioids. Health Alert Network 2018;Available at: https://emergency.cdc.gov/han/HAN00413.asp.
    1. New York City Department of Health and Mental Hygiene. Presence of fentanyl in cocaine contributing to increase in drug overdose deaths. Health Advisory 2017;Available at: https://www1.nyc.gov/assets/doh/downloads/pdf/han/advisory/fentanyl-advi....
    1. Colon-Berezin C, Nolan ML, Blachman-Forshay J and Paone D. Overdose deaths involving fentanyl and fentanyl analogs - New York City, 2000–2017. MMWR Morb Mortal Wkly Rep. 2019;68(2):37–40. - PMC - PubMed
    1. Nolan ML, Tuazon E and Paone D. Unintentional Drug Poisoning (Overdose) Deaths in New York City in 2019. New York City Department of Health and Mental Hygiene; December 2020.

Publication types