Barriers to establishing take-home naloxone programmes

Background:

Reducing the number of drug-related deaths is a priority in the current EU Drugs Strategy.

In Europe, among the >9000 annual overdose deaths, 84% involve opioids, making opioid deaths the focus of prevention efforts. Between 2015-2030, the target is to reduce deaths by 1/3. Take home naloxone (THN) programmes are important overdose reduction tools, however only 12 EU countries have established them.

To support countries’ response to overdose deaths, the EMCDDA has developed a diagnostic tool to assess barriers and facilitators to establishing take-home naloxone (THN) programmes, to expedite their introduction in European countries.

Methods

The EMCDDA contracted King’s College London (KCL) to develop a ‘diagnostic tool’; a checklist of barriers to establishing take-home naloxone programmes. The process included: KCL/EMCDDA brainstorming session, literature search, stakeholder validation of identified barriers, development of a manual of findings to be used at national roundtables concerning THN programmes. Launch: TBC

Results

Barriers or facilitators for establishing THN programme were grouped as follows: system-level barriers, including regulatory and legal obstacles, lack of advocacy, community stigma towards drug users, and lack of funding; THN provider level barriers, including high staff turnover and workload; naloxone first-reponder barriers, including lack of awareness/education about naloxone, and THN access issues.

Conclusion

Identifying and tackling regulatory and legal barriers to THN programmes, misperceptions and knowledge gaps, as well as the impact of drug-related stigma among the general population, providers, and first responders are important steps to improving the availability of THN. Removing some barriers requires changes to national regulatory systems, while others can be solved by increasing knowledge of staff and clients, and implementing simple changes in practice.