Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study

<h4>Introduction</h4> Take-Home Naloxone programs have been introduced across North America in response to rising opioid overdose deaths. There is currently limited real-world data on bystander naloxone administration, overdose outcomes, and evidence related to adverse events following b...

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Autores principales:	Amina Moustaqim-Barrette, Kristi Papamihali, Sierra Williams, Max Ferguson, Jessica Moe, Roy Purssell, Jane A. Buxton
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d7d12ac945ea4f28926692d2261ac3d2
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spelling	oai:doaj.org-article:d7d12ac945ea4f28926692d2261ac3d22021-11-04T07:42:09ZAdverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study1932-6203https://doaj.org/article/d7d12ac945ea4f28926692d2261ac3d22021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555799/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Introduction</h4> Take-Home Naloxone programs have been introduced across North America in response to rising opioid overdose deaths. There is currently limited real-world data on bystander naloxone administration, overdose outcomes, and evidence related to adverse events following bystander naloxone administration. <h4>Methods</h4> The research team used descriptive statistics from Take-Home Naloxone administration forms. We explored reported demographic variables and adverse events among people who received by-stander administered naloxone in a suspected opioid overdose event between August 31, 2012 and December 31, 2018 in British Columbia. We examined and contextualized differences across years given policy, program and drug toxicity changes. We used multivariate logistic regression to examine whether an association exists between number of ampoules of naloxone administered and the odds that the recipient will experience withdrawal symptoms. <h4>Results</h4> A large majority (98.1%) of individuals who were administered naloxone survived their overdose and 69.2% had no or only mild withdrawal symptoms. Receiving three (Adjusted Odds Ratio (AOR) 1.64 (95% Confidence Interval (CI): 1.08–2.48)) or four or more (AOR 2.19 (95% CI: 1.32–3.62)) ampoules of naloxone was significantly associated with odds of moderate or severe withdrawal compared to receiving one ampoule of naloxone. <h4>Conclusions</h4> This study provides evidence from thousands of bystander reversed opioid overdoses using Take-Home Naloxone kits in British Columbia, and suggests bystander-administered naloxone is safe and effective for opioid overdose reversal. Data suggests an emphasis on titration during bystander naloxone training in situations where the person experiencing overdose can be adequately ventilated may help avoid severe withdrawal symptoms. We identified a decreasing trend in the likelihood of moderate or severe withdrawal over the study period.Amina Moustaqim-BarretteKristi PapamihaliSierra WilliamsMax FergusonJessica MoeRoy PurssellJane A. BuxtonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Amina Moustaqim-Barrette Kristi Papamihali Sierra Williams Max Ferguson Jessica Moe Roy Purssell Jane A. Buxton Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study
description	<h4>Introduction</h4> Take-Home Naloxone programs have been introduced across North America in response to rising opioid overdose deaths. There is currently limited real-world data on bystander naloxone administration, overdose outcomes, and evidence related to adverse events following bystander naloxone administration. <h4>Methods</h4> The research team used descriptive statistics from Take-Home Naloxone administration forms. We explored reported demographic variables and adverse events among people who received by-stander administered naloxone in a suspected opioid overdose event between August 31, 2012 and December 31, 2018 in British Columbia. We examined and contextualized differences across years given policy, program and drug toxicity changes. We used multivariate logistic regression to examine whether an association exists between number of ampoules of naloxone administered and the odds that the recipient will experience withdrawal symptoms. <h4>Results</h4> A large majority (98.1%) of individuals who were administered naloxone survived their overdose and 69.2% had no or only mild withdrawal symptoms. Receiving three (Adjusted Odds Ratio (AOR) 1.64 (95% Confidence Interval (CI): 1.08–2.48)) or four or more (AOR 2.19 (95% CI: 1.32–3.62)) ampoules of naloxone was significantly associated with odds of moderate or severe withdrawal compared to receiving one ampoule of naloxone. <h4>Conclusions</h4> This study provides evidence from thousands of bystander reversed opioid overdoses using Take-Home Naloxone kits in British Columbia, and suggests bystander-administered naloxone is safe and effective for opioid overdose reversal. Data suggests an emphasis on titration during bystander naloxone training in situations where the person experiencing overdose can be adequately ventilated may help avoid severe withdrawal symptoms. We identified a decreasing trend in the likelihood of moderate or severe withdrawal over the study period.
format	article
author	Amina Moustaqim-Barrette Kristi Papamihali Sierra Williams Max Ferguson Jessica Moe Roy Purssell Jane A. Buxton
author_facet	Amina Moustaqim-Barrette Kristi Papamihali Sierra Williams Max Ferguson Jessica Moe Roy Purssell Jane A. Buxton
author_sort	Amina Moustaqim-Barrette
title	Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study
title_short	Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study
title_full	Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study
title_fullStr	Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study
title_full_unstemmed	Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study
title_sort	adverse events related to bystander naloxone administration in cases of suspected opioid overdose in british columbia: an observational study
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d7d12ac945ea4f28926692d2261ac3d2
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Adverse events related to bystander naloxone administration in cases of suspected opioid overdose in British Columbia: An observational study

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