Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, Sweden

Abstract Background Opioid use disorder is a chronic disorder with a high risk of overdose-related morbidity and mortality where a large proportion of these can be averted by timely administration of the antidote naloxone. For naloxone to be present when and where overdoses occur, broad-scale overdo...

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Main Authors: Katja Troberg, Pernilla Isendahl, Disa Dahlman, Anders Håkansson
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Harm Reduction Journal
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Online Access:https://doi.org/10.1186/s12954-025-01255-3
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author Katja Troberg
Pernilla Isendahl
Disa Dahlman
Anders Håkansson
author_facet Katja Troberg
Pernilla Isendahl
Disa Dahlman
Anders Håkansson
author_sort Katja Troberg
collection DOAJ
description Abstract Background Opioid use disorder is a chronic disorder with a high risk of overdose-related morbidity and mortality where a large proportion of these can be averted by timely administration of the antidote naloxone. For naloxone to be present when and where overdoses occur, broad-scale overdose education and naloxone distribution (OEND) must be established. A regional naloxone program was implemented in 2018, in Skåne County, Sweden. This five-year follow-up aims to describe all naloxone-related lay-person events, whether recommendations previously described in the literature were met, and to further investigate events conducted by individuals reporting overdose reversals with naloxone on three or more occasions (‘Supersavers’). Methods Between June 2018 and June 2023, data was collected in six-month intervals from 52 participating units, containing information on trained individuals, gender, year of birth and distributed naloxone kits. Upon naloxone replenishment, patients were asked whether previous naloxone had been used for overdose reversals on someone else, or themselves, had been lost, stolen, or given to someone else. Targets for naloxone distribution and program enrolment were set to a minimum of 20 kits per annual opioid overdose death, and 100 individuals at-risk per 100,000 inhabitants, respectively. Results Training and initial kits were provided to 2685 individuals at risk of own opioid overdose. Upon refill (n = 2,364), naloxone had been used for overdose reversal in 39% (n = 926) situations. In total, 5900 naloxone kits were distributed. Distribution target in relation to opioid overdose mortality was met annually, while the enrolment target was first met during the second year. The core group of Supersavers represent 9% (n = 50) of participants returning for refill while reporting 54.5% (n = 292) of all overdose reversals. Conclusions Broad-scale naloxone training and distribution reaches a large proportion of individuals at risk of opioid overdose. A continuous focus and priority in supporting units with a high prevalence of individuals witnessing overdose events is of great importance as these individuals report a large proportion of overdose reversals. Likewise, it is of great importance to provide these individuals, i.e. Supersavers, with needed and sufficient support for their continued essential work intervening in overdose situations. Trial registration Naloxone Treatment in Skåne County– Effect on Drug-related Mortality and Overdose-related Complications, NCT03570099, registered 26 June 2018.
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spelling doaj-art-8b2d9d1529374c04bf77a790e6204de62025-08-20T02:31:03ZengBMCHarm Reduction Journal1477-75172025-06-012211910.1186/s12954-025-01255-3Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, SwedenKatja Troberg0Pernilla Isendahl1Disa Dahlman2Anders Håkansson3Faculty of Medicine, Department of Clinical Sciences Lund, Lund UniversityDepartment of Infectious Disease, University Hospital SkåneFaculty of Medicine, Department of Clinical Sciences Lund, Lund UniversityFaculty of Medicine, Department of Clinical Sciences Lund, Lund UniversityAbstract Background Opioid use disorder is a chronic disorder with a high risk of overdose-related morbidity and mortality where a large proportion of these can be averted by timely administration of the antidote naloxone. For naloxone to be present when and where overdoses occur, broad-scale overdose education and naloxone distribution (OEND) must be established. A regional naloxone program was implemented in 2018, in Skåne County, Sweden. This five-year follow-up aims to describe all naloxone-related lay-person events, whether recommendations previously described in the literature were met, and to further investigate events conducted by individuals reporting overdose reversals with naloxone on three or more occasions (‘Supersavers’). Methods Between June 2018 and June 2023, data was collected in six-month intervals from 52 participating units, containing information on trained individuals, gender, year of birth and distributed naloxone kits. Upon naloxone replenishment, patients were asked whether previous naloxone had been used for overdose reversals on someone else, or themselves, had been lost, stolen, or given to someone else. Targets for naloxone distribution and program enrolment were set to a minimum of 20 kits per annual opioid overdose death, and 100 individuals at-risk per 100,000 inhabitants, respectively. Results Training and initial kits were provided to 2685 individuals at risk of own opioid overdose. Upon refill (n = 2,364), naloxone had been used for overdose reversal in 39% (n = 926) situations. In total, 5900 naloxone kits were distributed. Distribution target in relation to opioid overdose mortality was met annually, while the enrolment target was first met during the second year. The core group of Supersavers represent 9% (n = 50) of participants returning for refill while reporting 54.5% (n = 292) of all overdose reversals. Conclusions Broad-scale naloxone training and distribution reaches a large proportion of individuals at risk of opioid overdose. A continuous focus and priority in supporting units with a high prevalence of individuals witnessing overdose events is of great importance as these individuals report a large proportion of overdose reversals. Likewise, it is of great importance to provide these individuals, i.e. Supersavers, with needed and sufficient support for their continued essential work intervening in overdose situations. Trial registration Naloxone Treatment in Skåne County– Effect on Drug-related Mortality and Overdose-related Complications, NCT03570099, registered 26 June 2018.https://doi.org/10.1186/s12954-025-01255-3Take-home naloxoneOverdose education and naloxone distributionPeople who use opioidsHarm reduction
spellingShingle Katja Troberg
Pernilla Isendahl
Disa Dahlman
Anders Håkansson
Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, Sweden
Harm Reduction Journal
Take-home naloxone
Overdose education and naloxone distribution
People who use opioids
Harm reduction
title Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, Sweden
title_full Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, Sweden
title_fullStr Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, Sweden
title_full_unstemmed Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, Sweden
title_short Broad-scale overdose education and naloxone distribution– 5-year follow-up of a regional program in Skåne County, Sweden
title_sort broad scale overdose education and naloxone distribution 5 year follow up of a regional program in skane county sweden
topic Take-home naloxone
Overdose education and naloxone distribution
People who use opioids
Harm reduction
url https://doi.org/10.1186/s12954-025-01255-3
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