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Neighborhood and Individual Disparities in Community-Based Naloxone Access for Opioid Overdose Prevention.
Nesoff, Elizabeth D; Meisel, Zachary F; Saeed, Huda; Martins, Silvia S.
Afiliação
  • Nesoff ED; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, 423 Guardian Dr, Philadelphia, PA, 19104, USA. enesoff@upenn.edu.
  • Meisel ZF; Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, 423 Guardian Dr, Philadelphia, PA, 19104, USA.
  • Saeed H; Brown University, 75 Waterman Street, Providence, RI, 02912, USA.
  • Martins SS; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W168th St, 5th Floor, New York, NY, 10032, USA.
J Urban Health ; 101(1): 64-74, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38196059
ABSTRACT
Improving access to naloxone for laypersons is a cornerstone of the US strategy to reduce opioid overdose deaths. This study evaluated change in distance to opioid overdose prevention programs (OOPPs) providing walk-in naloxone across two time points. We also explored individual and neighborhood disparities in distance to OOPPs, associations between 2020 OOPP locations and 2018 overdoses, and associations between OOPPs and neighborhood fatal overdose rates. Using fatal opioid overdose locations in 2018 (n = 1167) and 2020 (n = 2045) in New York City, we mapped OOPP locations and fatal overdose locations to visualize areas of unmet naloxone need. We used logistic regression to assess individual (age, sex, race/ethnicity) and neighborhood correlates of odds of an overdose occurring within walking distance (≤ 0.5 miles or 0.8 km) of an OOPP and negative binomial regression to assess the relationship between census tract-level OOPP counts and overdose rates. Distance to OOPPs significantly improved over time, with average distance decreasing by 1.7 miles (2.7 km) (p < 0.001). OOPPs were more likely to be located in neighborhoods with higher poverty in both years and in closer proximity to Latinos in 2020-suggesting improved access for Latinos and in higher poverty neighborhoods. OOPP locations in 2020 were significantly positively associated with overdose locations in 2018. OOPPs were not well-situated in neighborhoods with elevated overdose rates in 2018 but were better situated in 2020, controlling for other neighborhood variables. Community lay naloxone access through OOPPs improved over time and could have promising effects for improved overdose rates in the future.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Overdose de Drogas / Overdose de Opiáceos / Transtornos Relacionados ao Uso de Opioides Limite: Humans Idioma: En Revista: J Urban Health Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Overdose de Drogas / Overdose de Opiáceos / Transtornos Relacionados ao Uso de Opioides Limite: Humans Idioma: En Revista: J Urban Health Assunto da revista: MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos