Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Susan G. Sherman, Johns Hopkins University, United States
- Second opponent: Professor Björn Johnson, Lund University, Sweden
- Third member and chair of the evaluation committee: Professor Odd Martin Vallersnes, University of Oslo
Chair of the Defence
Professor II Anners Lerdal, University of Oslo
Principal Supervisor
Researcher Desiree Eide, University of Oslo
Summary
Drug-induced deaths are considered a substantial public health problem globally. Over the past decades, the distribution of take-home naloxone (THN) to people who use drugs (PWUD) has gained acceptability and supportive evidence.
The aims of this thesis were to (1) assess the effectiveness and feasibility of expanding a THN programme through the use of digital tools; (2) to assess the appropriateness of the THN programme based on participant characteristics and THN use; and (3) to investigate mortality among participants with known risk factors for overdose.
All four studies used questionnaire based quantitative observational designs. In addition, one study applied a quasiexperimental component, and one study linked questionnaire data with data from the cause of death registry.
Staff members preferred the use of an electronic data collection form over paper (95%). Further, participants who completed the digital THN course increased their knowledge on all items measured. Additionally, participants reported subsequent naloxone distribution after course completion.
For those who received naloxone kits, participants who reported current opioid use was more likely to report naloxone use than others. Survival was reported in almost all cases (1202/1282, 94%) where THN was applied.
During the eight-year study-period, 8% (n=171) of the THN-programme participants died. Overdose was the most prevalent cause of death (49%). Solitary opioid use was associated with an elevated risk of dying.
The findings support the utilization of digital technologies for scaling up THN programmes. Further, PWUD are a suitable target group for THN-programmes, as they are willing and capable to reverse overdoses effectively. Additionally, THN participants at risk of overdosing experience excess mortality for various causes of death, supporting the importance of overdose prevention education as part of the naloxone distribution. The variety of mortality causes illustrates the need for multifaceted and targeted interventions for PWUD.
Additional information
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