Take-home naloxone programs for suspected opioid overdose in community settings: a scoping umbrella review

Abstract Background Opioid related overdoses and overdose deaths continue to constitute an urgent public health crisis. The implementation of naloxone programs, such as ‘take-home naloxone’ (THN), has emerged a key intervention in reducing opioid deaths. These programs aim train individuals at risk witnessing or experiencing recognize respond with naloxone. Naloxone effectively reverses on physiological level; however, there are outstanding questions community THN program effectiveness (adverse events, dosing requirements, dose-response between routes administration) (accessibility, availability, affordability). objective this scoping review is identify existing systematic reviews best practice guidelines relevant clinical operational guidance the distribution THN. Methods Using Arksey & O’Malley framework for reviews, we searched both academic literature grey databases using keywords (Naloxone) AND (Overdose) (Guideline OR Review Recommendation Toolkit). Only documents which had structured evidence and/or provided summaries recommendations based were included (systematic meta-analyses, short-cut rapid practice/clinical guidelines, reports). Data extracted from selected two areas: (1) study identifiers; (2) methodological characteristics. Results A total 47 articles met inclusion criteria: 20 reviews; 10 articles; 8 4 5 other types (e.g. mapping comprehensive reviews). most common subject themes were: effectiveness, safety, provision feasibility/acceptability distribution, administration, response after cost-effectiveness, training education, policy, gaps knowledge. Conclusions Several recent address take-home dosing/route models. Gaps remain around evaluating parameters strategies, adverse events following administration. As expand deaths, will contribute understanding base policy development expansion.