Who is using take-home naloxone? An examination of super-savers

As the opioid overdose crisis persists and take-home naloxone (THN) programmes expand, it is important that the intervention is targeted towards those most likely to use it. We examined THN program participants to 1) describe those that return for refills, specifically those that reported multiple use (super-savers) and 2) to determine what rescuer characteristics were associated with higher rates of THN use.

This study included a cohort of consenting THN recipients from June 2014- June 2021 who completed initial and refill questionnaires from a widespread program in Norway. Adjusted logistic regression was used to explore associations with higher rates of THN use. ‘Super-savers’ reported three or more THN uses.

A total of 1054 participants returned for a THN refill during the study period. Of these, 558 reported their last THN to have been used on an overdose. In the adjusted model, the only significant predictor for being a super-saver was previously witnessing 11-20 overdoses at baseline [AOR, 3.27 (1.18-9.07)]. Overall, those who returned for a refill were comparable, regardless of if their last THN had been used on an overdose.

Witnessing a high number of overdoses was subsequently associated with higher reports of THN use. THN programs should continue to emphasize and prioritize THN for people actively using drugs, particularly those who have witnessed overdoses previously