{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:33:14Z","timestamp":1789065194949,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,11,6]],"date-time":"2016-11-06T00:00:00Z","timestamp":1478390400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>It has been suggested that distributing naloxone to people who inject drugs (PWID) will lead to fewer attendances by emergency medical services at opioid\u2010related overdose incidents if peer administration of naloxone was perceived to have resuscitated the overdose victim successfully. This study evaluated the impact of a national naloxone programme (NNP) on ambulance attendance at opioid\u2010related overdose incidents throughout Scotland. Specifically, we aimed to answer the following research questions: is there evidence of an association between ambulance call\u2010outs to opioid\u2010related overdose incidents and the cumulative number of \u2018take\u2010home naloxone\u2019 (THN) kits in issue; and is there evidence of an association between ambulance call\u2010outs to opioid\u2010related overdose incidents in early adopter (pilot) or later adopting (non\u2010pilot) regions and the cumulative number of THN kits issued in those areas?<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Controlled time\u2013series analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Scotland, UK, 2008\u201315.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Pre\u2010NNP implementation period for the evaluation was defined as 1 April 2008 to 31 March 2011 and the post\u2010implementation period as 1 April 2011 to 31 March 2015. In total, 3721 ambulance attendances at opioid\u2010related overdose were recorded for the pre\u2010NNP implementation period across 158\u00a0weeks (mean 23.6 attendances per week) and 5258 attendances across 212\u00a0weeks in the post\u2010implementation period (mean 24.8 attendances per week).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Scotland's NNP; formally implemented on 1 April 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Primary outcome measure was weekly incidence (counts) of call\u2010outs to opioid\u2010related overdoses at national and regional Health Board level. Data were acquired from the Scottish Ambulance Service (SAS). Models were adjusted for opioid replacement therapy using data acquired from the Information Services Division on monthly sums of all dispensed methadone and buprenorphine in the study period. Models were adjusted further for a control group: weekly incidence (counts) of call\u2010outs to heroin\u2010related overdose in the London Borough area acquired from the London Ambulance Service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>There was no significant association between SAS call\u2010outs to opioid\u2010related overdose incidents and THN kits in issue for Scotland as a whole (coefficient 0.009, 95% confidence intervals\u00a0=\u00a0\u22120.01, 0.03, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.39). In addition, the magnitude of association between THN kits and SAS call\u2010outs did not differ significantly between pilot and non\u2010pilot regions (interaction test, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.62).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The supply of take\u2010home naloxone kits through a National Naloxone Programme in Scotland was not associated clearly with a decrease in ambulance attendance at opioid\u2010related overdose incidents in the 4\u2010year period after it was implemented in April 2011.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.13602","type":"journal-article","created":{"date-parts":[[2016,9,10]],"date-time":"2016-09-10T13:48:34Z","timestamp":1473515314000},"page":"301-308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Evaluating the impact of a national naloxone programme on ambulance attendance at overdose incidents: a controlled time\u2013series analysis"],"prefix":"10.1111","volume":"112","author":[{"given":"Andrew","family":"McAuley","sequence":"first","affiliation":[{"name":"Health Protection Scotland Meridian Court  Glasgow UK"},{"name":"School of Health and Life Sciences Glasgow Caledonian University  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Bouttell","sequence":"additional","affiliation":[{"name":"Institute of Health and Wellbeing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Barnsdale","sequence":"additional","affiliation":[{"name":"NHS National Services Scotland Information Services Division  Gyle Square Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mackay","sequence":"additional","affiliation":[{"name":"Institute of Health and Wellbeing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Lewsey","sequence":"additional","affiliation":[{"name":"Institute of Health and Wellbeing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Hunter","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde Possilpark Health and Care Centre  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Robinson","sequence":"additional","affiliation":[{"name":"Public Health Science Directorate NHS Health Scotland, Meridian Court  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511543692"},{"key":"e_1_2_8_3_1","volume-title":"Community management of opioid overdose","author":"World Health Organization (WHO)","year":"2014"},{"key":"e_1_2_8_4_1","unstructured":"DaviesC. 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