Opioids such as heroin kill more people worldwide than any other drug. In the UK, death from opioid poisoning is at record levels. Naloxone is an opioid agonist which can be distributed in take home ‘kits’, known as Take Home Naloxone (THN).
We are in the early stages of carrying out a randomised controlled feasibility trial (RCT) of THN distributed in emergency settings clustered by Emergency Department (ED) catchment area, and local ambulance service. The trial will include distribution of THN by paramedics and ED staff to patients at risk of opioid overdose. A discriminant function will be developed retrospectively identify people at high risk of overdose death using routine anonymised linked data.
We will gather anonymised linked data outcomes at one year including; deaths; emergency admissions; intensive care admissions; ED attendances; 999 attendances; THN kits issued; and NHS resource usage. We will agree progression criteria related to successful identification and provision of THN to eligible participants; successful follow up of eligible participants and opioid decedents; adverse event rate; successful data matching and data linkage; and retrieval of outcomes within three months of projected timeline.
THN programmes are currently run by some drug services in the UK. However, saturation is low. There has been a lack of experimental research in to THN, and so questions remain: Does THN reduce deaths? Are there unforeseen harms associated with THN? Is THN cost effective? This feasibility study will establish whether a fully powered cluster RCT can be used to answer these questions.