{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T21:31:27Z","timestamp":1781991087500,"version":"3.54.5"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T00:00:00Z","timestamp":1527033600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJEM"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1481803518003688_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>Take-home naloxone (THN) reduces deaths from opioid overdose. To increase THN distribution to at-risk emergency department (ED) patients, we explored reasons for patients\u2019 refusing or accepting THN.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803518003688_abs2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>In an urban teaching hospital ED, we identified high opioid overdose risk patients according to pre-specified criteria. We offered eligible patients THN and participation in researcher-administered surveys, which inquired about reasons to refuse or accept THN and about THN dispensing location preferences. We analyzed refusal and acceptance reasons in open-ended responses, grouped reasons into categories (absolute versus conditional refusals,) then searched for associations between patient characteristics and reasons.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803518003688_abs3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Of 247 patients offered THN, 193 (78.1%) provided reasons for their decision. Of those included, 69 (35.2%) were female, 91 (47.2%) were under age 40, 61 (31.6%) were homeless, 144 (74.6%) reported injection drug use (IDU), and 131 (67.9%) accepted THN. Of 62 patients refusing THN, 19 (30.7%) felt \u201cnot at risk\u201d for overdose, while 28 (45.2%) gave conditional refusal reasons: \u201ctoo sick,\u201d \u201cin a rush,\u201d or preference to get THN elsewhere. Non-IDU was associated with stating \u201cnot at risk,\u201d while IDU, homelessness, and age under 40 were associated with conditional refusals. Among acceptances, 86 (65.7%) mentioned saving others as a reason. Most respondents preferred other dispensing locations beside the ED, whether or not they accepted ED THN.<\/jats:p><\/jats:sec><jats:sec id=\"S1481803518003688_abs4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>ED patients refusing THN felt \u201cnot at risk\u201d for overdose or felt their ED visit was not the right time or place for THN. Most accepting THN wanted to save others.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cem.2018.368","type":"journal-article","created":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T07:29:44Z","timestamp":1527060584000},"page":"226-234","source":"Crossref","is-referenced-by-count":19,"title":["Yes, not now, or never: an analysis of reasons for refusing or accepting emergency department-based take-home naloxone"],"prefix":"10.1007","volume":"21","author":[{"given":"Andrew","family":"Kestler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Giesler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Buxton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gray","family":"Meckling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garth","family":"Hunte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Wilkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalya","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Scheuermeyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,5,23]]},"reference":[{"key":"S1481803518003688_ref16","doi-asserted-by":"publisher","DOI":"10.1111\/add.13778"},{"key":"S1481803518003688_ref11","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2015.2.24909"},{"key":"#cr-split#-S1481803518003688_ref1.1","unstructured":"1. 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