Skip to main content

Advertisement

Log in

Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Naloxone distribution to injecting drug users (IDUs) for peer administration is a suggested strategy to prevent fatal heroin overdose. The aim of this study was to explore attitudes of IDUs to administration of naloxone to others after heroin overdose, and preferences for method of administration. A sample of 99 IDUs (median age 35 years, 72% male) recruited from needle and syringe programs in Melbourne were administered a questionnaire. Data collected included demographics, attitudes to naloxone distribution, and preferences for method of administration. The primary study outcomes were attitudes of IDUs to use of naloxone for peer administration (categorized on a five-point scale ranging from “very good idea” to “very bad idea”) and preferred mode of administration (intravenous, intramuscular, and intranasal). The majority of the sample reported positive attitudes toward naloxone distribution (good to very good idea: 89%) and 92% said they were willing to participate in a related training program. Some participants raised concerns about peer administration including the competence of IDUs to administer naloxone in an emergency, victim response on wakening and legal implications. Most (74%) preferred intranasal administration in comparison to other administration methods (21%). There was no association with age, sex, or heroin practice. There appears to be strong support among Australian IDU for naloxone distribution to peers. Intranasal spray is the preferred route of administration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Darke S, Ross J, Hall W. Overdose among heroin users in Sydney, Australia: II. Responses to overdose. Addiction. 1996;91(3):413–417.

    Article  PubMed  CAS  Google Scholar 

  2. Strang J, Powis B, Best D, et al. Preventing opiate overdose fatalities with take-home naloxone: pre-launch study of possible impact and acceptability. Addiction. 1999;94(2):199–204.

    Article  PubMed  CAS  Google Scholar 

  3. McGregor C, Darke S, Ali R, Christie P. Experience of non-fatal overdose among heroin users in Adelaide, Australia: circumstances and risk perceptions. Addiction. 1998;93(5):701–711.

    Article  PubMed  CAS  Google Scholar 

  4. Darke S, Ross J, Zador D, Sunjic S. Heroin-related deaths in New South Wales, Australia, 1992–1996. Drug Alcohol Depend. 2000;60(2):141–150.

    Article  PubMed  CAS  Google Scholar 

  5. Davidson PJ, Ochoa KC, Hahn JA, Evans JL, Moss AR. Witnessing heroin-related overdoses: the experiences of young injectors in San Francisco. Addiction. 2002;97(12):1511–1516.

    Article  PubMed  Google Scholar 

  6. Seal KH, Downing M, Kral AH, et al. Attitudes about prescribing take-home naloxone to injection drug users for the management of heroin overdose: a survey of street-recruited injectors in the San Francisco Bay Area. J Urban Health. 2003;80(2):291–301.

    PubMed  Google Scholar 

  7. Tracy M, Piper TM, Ompad D, et al. Circumstances of witnessed drug overdose in New York City: implications for intervention. Drug Alcohol Depend. 2005;79(2):181–190.

    Article  PubMed  Google Scholar 

  8. Darke S, Hall W. The distribution of naloxone to heroin users. Addiction. 1997;92(9):1195–1199.

    Article  PubMed  CAS  Google Scholar 

  9. Lenton SR, Hargreaves KM. Should we conduct a trial of distributing naloxone to heroin users for peer administration to prevent fatal overdose? Med J Aust. 2000;173(5):260–263.

    PubMed  CAS  Google Scholar 

  10. Sporer KA, Kral AH. Prescription naloxone: a novel approach to heroin overdose prevention. Ann Emerg Med. 2007;49(2):172–177.

    Article  PubMed  Google Scholar 

  11. Baca CT, Grant KJ. Take-home naloxone to reduce heroin death. Addiction. 2005;100(12):1823–1831.

    Article  PubMed  Google Scholar 

  12. Wright N, Oldham N, Francis K, Jones L. Homeless drug users’ awareness and risk perception of peer “Take Home Naloxone” use—a qualitative study. Subst Abuse Treat Prev Policy. 2006;1:28.

    Article  PubMed  Google Scholar 

  13. Seal KH, Thawley R, Gee L, et al. Naloxone distribution and cardiopulmonary resuscitation training for injection drug users to prevent heroin overdose death: a pilot intervention study. J Urban Health. 2005;82(2):303–311.

    PubMed  Google Scholar 

  14. Worthington N, Markham Piper T, Galea S, Rosenthal D. Opiate users’ knowledge about overdose prevention and naloxone in New York City: a focus group study. Harm Reduct. 2006;3:19.

    Google Scholar 

  15. Tobin KE, Gaasch WR, Clarke C, MacKenzie E, Latkin CA. Attitudes of emergency medical service providers towards naloxone distribution programs. J Urban Health. 2005;82(2):296–302.

    PubMed  Google Scholar 

  16. Mountain D. Take home naloxone for opiate addicts Big conclusions are drawn from little evidence. BMJ. 2001;323(7318):934, author reply 5.

    Article  PubMed  CAS  Google Scholar 

  17. Ashworth AJ, Kidd A. Take home naloxone for opiate addicts. Apparent advantages may be balanced by hidden harms. BMJ. 2001;323(7318):935.

    Article  PubMed  CAS  Google Scholar 

  18. Dettmer K, Saunders B, Strang J. Take home naloxone and the prevention of deaths from opiate overdose: two pilot schemes. BMJ. 2001;322(7291):895–896.

    Article  PubMed  CAS  Google Scholar 

  19. Stata Statistical Software: release 8.2. College Station, Texas Stata Corporation, 2003.

  20. DHS. The Victorian drug statistics handbook 2006: patterns of drug use and related harm in Victoria. Melbourne, Victoria: Drugs Policy and Services Branch, Rural and Regional Health and Aged Care Services Division; 2006.

  21. Lagu T, Anderson BJ, Stein M. Overdoses among friends: drug users are willing to administer naloxone to others. J Subst Abuse Treat. 2006;30(2):129–133.

    Article  PubMed  Google Scholar 

  22. Kelly AM, Kerr D, Dietze P, et al. Randomised trial of intranasal versus intramuscular naloxone in prehospital treatment for suspected opioid overdose. Med J Aust. 2005;182(1):24–27.

    Google Scholar 

  23. Robertson T, Hendey G, Stroh G, Shalit M. Intranasal versus intravenous naloxone for prehospital narcotic overdose (abstract). Acad Emerg Med. 2005;12:s166–s167.

    Article  Google Scholar 

  24. Baca CT, Grant KJ. What heroin users tell us about overdose. J Addict Dis. 2007;26(4):63–68.

    Article  PubMed  Google Scholar 

  25. Dietze P, Fry C, Rumbold G, Gerostamoulos J. The context, management and prevention of heroin overdose in Victoria, Australia: the promise of a diverse approach. Addiction Research and Theory. 2001;9(5):437–458.

    Article  Google Scholar 

  26. Cantwell K, Dietze P, Flander L. The relationship between naloxone dose and key patient variables in the treatment of non-fatal heroin overdose in the prehospital setting. Resuscitation. 2005;65(3):315–319.

    Article  PubMed  CAS  Google Scholar 

  27. Maxwell S, Bigg D, Stanczykiewicz K, Carlberg-Racich S. Prescribing naloxone to actively injecting heroin users: a program to reduce heroin overdose deaths. J Addict Dis. 2006;25(3):89–96.

    Article  PubMed  Google Scholar 

  28. Sherman SG, Gann DS, Scott G, Carlberg S, Bigg D, Heimer R. A qualitative study of overdose responses among Chicago IDUs. Harm Reduct J. 2008;5(1):2.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge staff of the three needle and syringe programs who provided access to potential candidates and a suitable environment for interviews, in particular Colin Coxhead, Sue White, and Jacqui Brown. The authors wish to thank the respondents for their participation.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Debra Kerr.

Additional information

Kerr and Kelly are with the Joseph Epstein Centre for Emergency Medicine Research, Sunshine Hospital, St. Albans, Victoria, Australia; Kerr and Kelly are with the The University of Melbourne, Melbourne, Victoria, Australia; Dietze is with the Burnet Institute, Melbourne, Victoria, Australia; Dietze and Jolley are with the Monash Institute of Health Services Research, Melbourne, Victoria, Australia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kerr, D., Dietze, P., Kelly, AM. et al. Attitudes of Australian Heroin Users to Peer Distribution of Naloxone for Heroin Overdose: Perspectives on Intranasal Administration. J Urban Health 85, 352–360 (2008). https://doi.org/10.1007/s11524-008-9273-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-008-9273-z

Keywords

Navigation