Ai Rene Ong1, Sunghee Lee2, Erin E Bonar3. 1. Institute for Social Research, 426 Thompson St, Ann Arbor, MI 48104, United States. Electronic address: aireneo@umich.edu. 2. Institute for Social Research, 426 Thompson St, Ann Arbor, MI 48104, United States. Electronic address: sungheel@umich.edu. 3. Addiction Center, Department Psychiatry, University of Michigan, 2800 Plymouth Road, Building 16 210E, Ann Arbor, MI 48109, United States; Injury Prevention Center, University of Michigan, 2800 Plymouth Road, Building 10, Ann Arbor, MI 48109, United States; Institute for Healthcare Policy and Innovation, University of Michigan, 2800 Plymouth Road, Building 16, Ann Arbor, MI 48109, United States. Electronic address: erinbona@med.umich.edu.
Abstract
BACKGROUND: Given the rising incidence of opioid overdose in the United States, naloxone access is critical for high-risk populations, such as persons who inject drugs (PWID). Yet not all PWID have access to this life-saving antidote. With PWID in Michigan recruited via respondent driven sampling in 2017, after the 2016 standing order expanding naloxone availability through local pharmacies, we explored possible access disparities. METHODS: With 46 seeds recruited from agencies serving local PWID communities, we obtained a sample of N = 410 PWID from Southeast Michigan (n = 285 form urban Detroit, and 125 for suburban/rural areas outside Detroit). Participants completed questionnaires detailing socio-demographics, health history, substance use and treatment access, including naloxone. We used multiple logistic regression to examine the predictors of self-reported naloxone access based on participant characteristics (e.g., demographics, health status) and geography (urban vs. suburban/rural). RESULTS: Self-reported naloxone access differed significantly by location (urban = 18.3 %; suburban/rural = 41.9 %). In multivariable analyses, naloxone access was significantly associated with race, household income, employment, health insurance, recent homelessness, prescription opioid usage, Hepatitis A and C status, Hepatitis A vaccination, Hepatitis C testing, access to drug treatment and services, and hospital as the usual place of care. CONCLUSION: Despite recent policies to expand access, our results indicate that naloxone access among high-risk PWID is low. This warrants future research to identify effective channels to reduce barriers and increase naloxone access.
BACKGROUND: Given the rising incidence of opioid overdose in the United States, naloxone access is critical for high-risk populations, such as persons who inject drugs (PWID). Yet not all PWID have access to this life-saving antidote. With PWID in Michigan recruited via respondent driven sampling in 2017, after the 2016 standing order expanding naloxone availability through local pharmacies, we explored possible access disparities. METHODS: With 46 seeds recruited from agencies serving local PWID communities, we obtained a sample of N = 410 PWID from Southeast Michigan (n = 285 form urban Detroit, and 125 for suburban/rural areas outside Detroit). Participants completed questionnaires detailing socio-demographics, health history, substance use and treatment access, including naloxone. We used multiple logistic regression to examine the predictors of self-reported naloxone access based on participant characteristics (e.g., demographics, health status) and geography (urban vs. suburban/rural). RESULTS: Self-reported naloxone access differed significantly by location (urban = 18.3 %; suburban/rural = 41.9 %). In multivariable analyses, naloxone access was significantly associated with race, household income, employment, health insurance, recent homelessness, prescription opioid usage, Hepatitis A and C status, Hepatitis A vaccination, Hepatitis C testing, access to drug treatment and services, and hospital as the usual place of care. CONCLUSION: Despite recent policies to expand access, our results indicate that naloxone access among high-risk PWID is low. This warrants future research to identify effective channels to reduce barriers and increase naloxone access.
Authors: Akash Gupta; Fatma M Shebl; Yao Tong; Katherine Wagner; Ingrid V Bassett; Kimberly Page; Erin L Winstanley Journal: Addict Sci Clin Pract Date: 2022-10-20
Authors: Alex S Bennett; Joy Scheidell; Jeanette M Bowles; Maria Khan; Alexis Roth; Lee Hoff; Christina Marini; Luther Elliott Journal: Harm Reduct J Date: 2022-03-04
Authors: Jaclyn M W Hughto; Lily K Gordon; Thomas J Stopka; Patricia Case; Wilson R Palacios; Abigail Tapper; Traci C Green Journal: Subst Abus Date: 2021-07-06 Impact factor: 3.984