Researchers at the University of North Carolina at Chapel Hill and partners have found evidence that community-based naloxone distribution programs are associated with lower opioid overdose death rates. In counties where more than 100 naloxone kits were distributed per 100,000 people the opioid overdose death rate was 14% lower than in counties where kits were not distributed. This is one of the first studies examining the effectiveness of community-based naloxone distribution on opioid overdose deaths. 

The study’s findings were published on August 30, 2019, in Drug & Alcohol Dependence

Opioid overdose deaths have sharply increased over the past two decades. In 2017 the number of opioid overdose deaths was six times higher than in 1999 across the country. In North Carolina, between 2014 and 2017 the number of opioid deaths doubled (from 962 to 2,006). Communities nationally and in North Carolina alike have mobilized to curb the opioid overdose epidemic. A key overdose prevention strategy is community-based distribution of naloxone, an opioid antagonist that can quickly reverse an overdose. In 2013, the North Carolina Harm Reduction Coalition formalized a program to distribute naloxone kits in communities throughout the state. The North Carolina Harm Reduction Coalition’s community-based program prioritizes distributing naloxone kits and providing training on reversing overdoses to people actively using drugs and people in recovery who then administer naloxone in their communities. 

Rebecca Naumann, assistant professor of epidemiology at the UNC Gillings School of Global Public Health and core faculty at the UNC Injury Prevention Research Center, is the lead author of the study. “The findings of this study demonstrate the impact and importance of community-based naloxone distribution programs. The North Carolina Harm Reduction Coalition is an invaluable asset to communities across the state, and this study documents one critical part of their life-saving work.”

Naumann and her team analyzed county-level data of naloxone kits distributed from 2013-2016 and mortality data from 2000-2016. They also conducted a cost-benefit analysis to examine potential economic benefits of the naloxone distribution program. The results demonstrated that for every dollar spent on the distribution program, there was $2,742 of benefit due to avoided opioid overdose deaths. 

The findings of this study support the expansion of naloxone distribution programs across North Carolina and the country to help address the opioid epidemic. 

Preliminary 2018 data from the North Carolina Department of Health and Human Services indicates a decline in opioid overdose deaths and emergency department visits in North Carolina for the first time in five years. “While recent data suggest a welcome change in the trend of opioid overdose deaths, we know that there is still substantial work to do. This study demonstrates the importance of investment in harm reduction strategies, like those included in the North Carolina Opioid Action Plan and Research Agenda, as we continue to confront this crisis,” said Susan Kansagra, Chief of Chronic Disease and Injury for the NC Division of Public Health.  

Research collaborators on this study included representatives from the North Carolina Department of Health and Human Services, North Carolina Harm Reduction Coalition, UNC Department of Public Policy, and the Department of Maternal and Child Health at the Gillings School of Global Public Health. 

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