TOPLINE

Non-medically trained people who used opioids successfully recognised and reversed peer overdose events using take-home naloxone (THN) kits in 83% of witnessed events, a multicountry prospective cohort study found.

METHODOLOGY

• Researchers conducted a multicountry prospective cohort study across 22 drug treatment and harm reduction services in England, Wales, Scotland, and Sweden.
• The study enrolled 1025 individuals who used opioids and were supplied with THN between 2021 and 2023 and systematically followed 594 of them for 6 months via monthly text messages and structured interviews.
• THN kits with either injectable naloxone (multidose 2 mg naloxone in a prefilled syringe) or nasal naloxone (2 × 1.8 mg or 2 × 1.26 mg) were supplied to the participants at enrolment.
• Participants reported any witnessed overdose events, the accuracy of identifying opioid crises, the availability and route of administration of naloxone, and patient outcomes.
• Outcomes were compared between participants under treatment for opioid use disorder (n = 515) and those using opioids but not under treatment (n = 79).

TAKEAWAY

• A total of 160 participants witnessed at least one overdose (total events, 278); of these, 90% reported that naloxone was available at the event, with 62% reporting that only their own naloxone kit was available. Naloxone was administered in 83% of events, with 77% of participants administering it themselves.
• Participants not under treatment were fourfold more likely to witness an overdose than those under treatment (56% vs 23%; odds ratio, 4.4; P < .001).
• Fatal outcomes of an overdose were reported in 4.6% of events; however, participants witnessing these events believed that naloxone had been administered after death.
• A total of 95% of participants recognised at least one critical sign of overdose and 97.5% reported taking appropriate action.

IN PRACTICE

"People who use opioids are likely to witness and recognise an opioid overdose, be the only person carrying naloxone at the overdose and be both willing and able to safely and effectively administer naloxone in a timely response," the authors wrote.

"These findings strongly support further public health measures aimed at increasing access to THN among people who themselves use opioids," they added.

SOURCE

The study was led by Nicola Metrebian, King's College London, London, England. It was published online on July 12, 2026, in Addiction.

LIMITATIONS

The study was limited by a follow-up rate of 58% among a high-risk population, reliance on self-reported data and overdose outcomes, potential recall bias, selection bias, potential lack of complete information among participants regarding the circumstances or individuals involved, and lower-than-anticipated overall recruitment.

DISCLOSURES

The study received funding from Mundipharma Research Limited and King's College London. Several authors reported receiving research grants, project support, honoraria, or consultancy fees from pharmaceutical companies, including Mundipharma, Camurus AB, Indivior, PneumoWave, Accord, Navamedic, and Gilead, and from the National Institute for Health and Care Research.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.