{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:07:19Z","timestamp":1790060839424,"version":"4.0.1"},"reference-count":32,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009780","name":"Region Sk\u00e5ne","doi-asserted-by":"publisher","award":["none"],"award-info":[{"award-number":["none"]}],"id":[{"id":"10.13039\/501100009780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,11,20]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Distribution of take-home naloxone is suggested to reduce opioid-related fatalities, but few studies have examined the effects on overdose deaths in the general population of an entire community. This study aimed to assess the effects on overdose deaths of a large-scale take-home naloxone programme starting in June 2018, using an observational design with a historic control period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>From the national causes of death register, deaths diagnosed as X42 or Y12 (International Classification of Diseases, 10th revision, ICD-10) were registered as overdoses. Numbers of overdoses were calculated per 100\u2009000 inhabitants in the general population, and controlled for data including only individuals with a prior substance use disorder in national patient registers, to focus on effects within the primary target population of the programme. The full intervention period (2019\u20132021) was compared with a historic control period (2013\u20132017).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Sk\u00e5ne county, Sweden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>General population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Large-scale take-home naloxone distribution to individuals at risk of overdose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Decrease in overdose deaths per 100\u2009000 inhabitants, in total and within the population with substance use disorder diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Annual average number of overdose deaths decreased significantly from 3.9 to 2.8 per 100\u2009000 inhabitants from the control period to the intervention period (a significant decrease in men, from 6.7 to 4.3, but not in women, from 1.2 to 1.3). Significant changes remained when examining only prior substance use disorder patients, and decreases in overdose deaths could not be attributed to a change in treatment needs for opioid use disorders in healthcare and social services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present study, involving 3\u2009years of take-home naloxone distribution, demonstrated a decreased overdose mortality in the population, however, only in men. The findings call for further implementation of naloxone programmes, and for further studies of potential effects and barriers in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03570099\">NCT03570099<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-074152","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:18:45Z","timestamp":1704845925000},"page":"e074152","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Distribution of intranasal naloxone to potential opioid overdose bystanders in Sweden: effects on overdose mortality in a full region-wide study"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct03570099","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5800-8975","authenticated-orcid":false,"given":"Anders","family":"H\u00e5kansson","sequence":"first","affiliation":[{"name":"Psychiatry, Lund University, Lund, Sweden"},{"name":"Malm\u00f6 Addiction Center, Region Sk\u00e5ne, Malmo, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Alanko Blom\u00e9","sequence":"additional","affiliation":[{"name":"Clinical Infection Medicine, Lund University, Lund, Sweden"},{"name":"Region Sk\u00e5ne, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernilla","family":"Isendahl","sequence":"additional","affiliation":[{"name":"Sk\u00e5ne University Hospital, Region Sk\u00e5ne, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Landgren","sequence":"additional","affiliation":[{"name":"Region Sk\u00e5ne, Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Malmqvist","sequence":"additional","affiliation":[{"name":"Region Sk\u00e5ne, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Troberg","sequence":"additional","affiliation":[{"name":"Malm\u00f6 Addiction Center, Region Sk\u00e5ne, Malmo, Sweden"},{"name":"Clinical Infection Medicine, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"2025121523583546000_14.1.e074152.1","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugpo.2019.102616","article-title":"Opioid-related deaths in Europe: strategies for a comprehensive approach to address a major public health 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Available: https:\/\/www.socialstyrelsen.se\/globalassets\/sharepoint-dokument\/artikelkatalog\/statistik\/2022-6-7915.pdf"},{"key":"2025121523583546000_14.1.e074152.31","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1080\/15563650.2018.1529319","article-title":"Challenges with take-home naloxone in reducing heroin mortality: a review of fatal heroin overdoses in Victoria, Australia","volume":"57","author":"Stam","year":"2019","journal-title":"Clin Toxicol (Phila)"},{"key":"2025121523583546000_14.1.e074152.32","doi-asserted-by":"crossref","DOI":"10.1186\/s12954-022-00647-z","article-title":"Who is using take-home naloxone? an examination of Supersavers","volume":"19","author":"Eide","year":"2022","journal-title":"Harm Reduct J"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-074152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T07:58:45Z","timestamp":1765871925000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-074152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,3]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/bmjopen-2023-074152"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-074152","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}