title: Predictors of seeking emergency medical help during overdose events in a provincial naloxone distribution programme: a retrospective analysis.
abstract: This study sought to identify factors that may be associated with help-seeking by witnesses during overdoses where naloxone is administered.
  
  
  
  Overdose events occurred in and were reported from the five regional health authorities across British Columbia, Canada. Naloxone administration forms completed following overdose events were submitted to the British Columbia Take Home Naloxone programme.
  
  
  
  All 182 reported naloxone administration events, reported by adult men and women and occurring between 31 August 2012 and 31 March 2015, were considered for inclusion in the analysis. Of these, 18 were excluded: 10 events which were reported by the person who overdosed, and 8 events for which completed forms did not indicate whether or not emergency medical help was sought.
  
  
  
  Seeking emergency medical help (calling 911), as reported by participants, was the sole outcome measure of this analysis.
  
  
  
  Medical help was sought (emergency services-911 called) in 89 (54.3%) of 164 overdoses where naloxone was administered. The majority of administration events occurred in private residences (50.6%) and on the street (23.4%), where reported rates of calling 911 were 27.5% and 81.1%, respectively. Overdoses occurring on the street (compared to private residence) were significantly associated with higher odds of calling 911 in multivariate analysis (OR=10.68; 95% CI 2.83 to 51.87; p<0.01), after adjusting for other variables.
  
  
  
  Overdoses occurring on the street were associated with higher odds of seeking emergency medical help by responders. Further research is needed to determine if sex and stimulant use by the person who overdosed are associated with seeking emergency medical help. The results of this study will inform interventions within the British Columbia Take Home Naloxone programme and other jurisdictions to encourage seeking emergency medical help.
authors.affiliation: Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Graham
authors.initials: G
authors.lastname: Ambrose
authors.affiliation: Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Amlani
authors.affiliation: Communicable Disease Prevention and Control Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Buxton
mesh_terms: D000328:Adult; D001955:British Columbia; D062787:Drug Overdose / Q000188:drug therapy* / Q000453:epidemiology; D004632:Emergency Medical Services; D005260:Female; D019538:Health Care Surveys; D006556:Heroin Dependence / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage*; D009292:Narcotic Antagonists / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone
keywords: ACCIDENT & EMERGENCY MEDICINE; PUBLIC HEALTH