title: Attitudes of Australian heroin users to peer distribution of naloxone for heroin overdose: perspectives on intranasal administration.
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.
authors.affiliation: Joseph Epstein Centre for Emergency Medicine Research, Sunshine Hospital, 1st Floor, 176 Furlong Rd, St Albans, Victoria, 3021, Australia. Debbie.Kerr@wh.org.au
authors.forename: Debra
authors.initials: D
authors.lastname: Kerr
authors.forename: Paul
authors.initials: P
authors.lastname: Dietze
authors.forename: Anne-Maree
authors.initials: AM
authors.lastname: Kelly
authors.forename: Damien
authors.initials: D
authors.lastname: Jolley
mesh_terms: D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001315:Australia / Q000453:epidemiology; D062787:Drug Overdose / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006556:Heroin Dependence / Q000401:mortality / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage* / Q000600:supply & distribution; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000600:supply & distribution; D010379:Peer Group; D015819:Substance Abuse, Intravenous / Q000401:mortality* / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D019037:Urban Health Services
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone