Optimizing public placement of naloxone kits to save lives

Making it easy to access naloxone kits to reverse the effects of opioid poisoning will help save lives, according to research published in theCanadian Medical Association Journal) that looks at the best placements for these kits.

Researchers wanted to understand the best placement for public-access naloxone kits in Vancouver, British Columbia, to help prevent deaths from opioid poisoning. They compared public access strategies for more than 14 000 opioid poisonings over six years.

They looked at placement at existing locations of take-home naloxone, at public locations like chain businesses, and at public transit locations. They found that kits placed at public transit locations, using criteria similar to those in an optimization strategy for placing automated external defibrillators, had the best coverage for reversing opioid poisonings, with fewer kits needing to be placed.

Placing publicly accessible naloxone kits at transit stations using the optimization-driven strategy and ensuring blanket placement at take-home naloxone program locations, which distribute free naloxone kits to community members, helped cover a major proportion of opioid poisonings in Vancouver.

“Optimization-driven placement can identify locations where opioid poisonings are most concentrated and therefore where naloxone kits are most valuable, leading to coverage especially in areas not covered by other strategies,” writes Dr. K.H. Benjamin Leung, a research fellow in health systems engineering, Duke University, Durham, North Carolina, with co-authors.

“Overall, a combination of blanket naloxone kit placement at take-home naloxone locations and optimization-driven placement in areas underserved by the take-home naloxone program may be the best approach.”

The authors hope these findings will help decision-makers optimize the accessibility of naloxone kits to prevent deaths from opioid poisoning.

“For public-access naloxone programs to be successful, naloxone kits must be easily accessible at all times, which may be achieved by placement on the exterior of buildings along with clear indicative signage,” the authors conclude.