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Cited by 17Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesHIV, Drug Use, Sexual Risk

One opioid user saving another: the first study of an opioid overdose-reversal and naloxone distribution program addressing hard-to-reach drug scenes in Denmark

Open access
Thylstrup, Birgitte, Hesse, Morten, Jørgensen, Marian, Thiesen, Henrik·2019·Harm Reduction Journal
DOI 10.1186/s12954-019-0328-0PMC PMC6896775
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Abstract

Background: Overdose education and naloxone distribution programs decrease opioid overdose deaths. However, no studies of such programs have been carried out in Denmark. The aim of this study was to evaluate the feasibility and the effect of a broader “training-the-trainers” model in low-threshold settings after participation in the “Danish Save Lives” [SL] program. Methods: Between May 2013 and November 2015, 552 participants from four municipalities took part in the SL program. The program is built on the train-the-trainers model where a central trainer trains others (trainers), who in turn train others (helpers). Participants were 30 police officers (5%), 188 people who use opioids (34%), 23 significant others (4%), and 217 social workers (39%). Ninety-four participants could not be classified (17%). At follow-up, participants were interviewed to determine the number and outcomes of opioid overdoses. Logistic regression was used to assess predictors of treating an overdose. Results: In all, 37 (7%) participants had intervened in 45 opioid overdose events (two trainers and 35 helpers). Detailed descriptions of the overdose event were available from 32 follow-up interviews (70%). In 16 cases, the person who intervened was already present at the site when the overdose occurred, and in 17 cases, the overdose victim recovered without complications. All overdose victims survived except one. People who used opioids were more likely to have treated an overdose than other participants (adjusted odds ratio [AOR] = 8.50, p = 0.001), and the likelihood of treating and overdose declined over time AOR = 0.37 (0.13, 0.93), p = 0.034). Conclusions: Prevention programs that target people who use opioids are more likely to be effective than programs that target professionals, especially in high-risk settings that can be hard for paramedics to reach. A future goal is to explore how prevention programs can be adapted to new user groups. Trial registration: The Danish Data Protection Agency, 2015-57-0002, Aarhus University, 2016-051-000001, 184, retrospectively registered

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  • In the only study enrolling PWUD, family members, other community members, and police together, the odds of PWUD administering naloxone to reverse an overdose were more than 8 times the odds for people in the other groups.

    “In the only study in our review to enroll PWUD, family members, other community members, and police all in the same study, the odds of PWUD administering naloxone to someone to reverse an overdose were more than 8 times the odds that people in the other groups did so [33].”

    From Effectiveness of naloxone distribution in community settings to reduce opioid overdose deaths among people who use drugs: a systematic review and meta-analysis (2025) · cites this paper as [33]

    The Abstract (Results) reports that people who used opioids had 8.50 times the adjusted odds of treating an overdose compared with other participants. But the Results (Treatment of ODs) say only 65% of those who treated an overdose reported administering naloxone; the paper does not report an 8.50 odds ratio specifically for administering naloxone. (LLM, conf=0.90)

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Research works printed but not linked: 1

  1. [29]EMCDDA. National report (2013 data) to the EMCDDA, vol. 2014. Copenhagen: Danish Health and Medicines Authority; 2014.

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Authors
Thylstrup, B., Hesse, M., Jørgensen, M., & Thiesen, H.
Affiliations
Aarhus University (DK)
Corresponding author
Thylstrup, Birgitte
ORCID
Venue
Harm Reduction Journal
Publisher
Springer Science and Business Media LLC
Published
2019-12
Volume
16
Issue
1
Pages
66-66
ISSN
1477-7517 (ISSN-L)
DOI
10.1186/s12954-019-0328-0
PMC
PMC6896775
OpenAlex
W2992084561
Cited by
17
References
63
Citations by year
2026: 2 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 2
FWCI
1.84
Type
journal article
Language
en
Open access
Licence
Locations
  • Harm Reduction Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
opioid overdose, naloxone distribution, overdose reversal, people who use opioids, harm reduction, overdose prevention, social workers, police officers, significant others, paramedics
MeSH terms
Teacher Training, Adult, Aged, Aged, 80 and over, Denmark, Education, Female, First Aid, Follow-Up Studies, Helping Behavior, Humans, Interview, Psychological, Male, Middle Aged, Naloxone, Retrospective Studies, Risk-Taking, Social Environment, Young Adult, Drug Overdose

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