A rapid assessment of take-home naloxone provision during COVID-19 in Europe

Rebecca McDonald*, Desiree Eide, Katri Abel-Ollo, Lee Barnstable, Ben Carter, Thomas Clausen, Ed Day, Francina Fonseca, Elin Holmen, Kirsten Horsburgh, Mike Kelleher, Martin Kåberg, Martin Ladenhauf, Andrew McAuley, Nicola Metrebian, Joanne Neale, Stephen Parkin, Kevin Ratcliffe, Chris Rintoul, Josie SmithViktorija Stifanoviciute, Marta Torrens, Henrik Thiessen, John Strang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
In March 2020, the World Health Organization declared COVID-19 a global pandemic. In the following weeks, most European countries implemented national lockdowns to mitigate viral spread. Services for people who use drugs had to quickly revise their operating procedures to rearrange service provision while adhering to lockdown requirements. Given the scarcity of literature published on overdose prevention during COVID-19 in Europe, we aimed to examine how these changes to service provision affected take-home naloxone (THN) programmes and naloxone availability across Europe.

Methods
Between November 2020 and January 2021, we conducted a rapid assessment with country experts from European countries that provide THN. We sent country experts a template to report monthly THN distribution data (January 1, 2019-October 31, 2020) and a structured 6-item survey for completion.

Results
Responses were received from 14 of the 15 European countries with THN provision of which 11 participated in the rapid assessment: Austria, Denmark, England, Estonia, Lithuania, Northern Ireland, Norway, Scotland, Spain (Catalonia only), Sweden, and Wales. All reported reduced organisational capacity during COVID-19, and some put into place a range of novel approaches to manage the restrictions on face-to-face service provision. In six countries, the introduction of programme innovation occurred alongside the publication of government guidelines recommending increased THN provision during COVID-19. Eight of the eleven participating countries managed to maintain 2019-level monthly THN distribution rates or even increase provision during the pandemic.

Conclusion
Through programme innovation supported by public guidelines, many European THN programmes managed to ensure stable or even increased THN provision during the pandemic, despite social distancing and stay-at-home orders affecting client mobility.
Original languageEnglish
Article number103787
JournalInternational Journal of Drug Policy
Volume107
Early online date16 Jul 2022
DOIs
Publication statusPublished - Sep 2022

Keywords

  • heroin
  • opiate
  • coronavirus
  • harm reduction
  • opioid
  • overdose

ASJC Scopus subject areas

  • Health Policy
  • Medicine (miscellaneous)

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