Norway’s Take-Home Naloxone Project
Opioid overdoses are a significant health problem in Norway, and despite good treatment coverage and extensive harm reduction efforts, Norway has among the highest overdose rates in Europe. In response to this issue, in 2014 the Norwegian Directorate of Health launched a National Overdose Strategy that included the distribution of naloxone.
The program began as a pilot project in Norway’s two largest cities, Oslo and Bergen, and has since expanded to over 100 municipalities via 400 distribution sites.
Naloxone is primarily distributed via low-threshold facilities but is also available at treatment centers, shelters, and prisons. Staff working in these facilities are trained to distribute naloxone. Other groups who are in contact with people at risk of overdosing have also been trained in the use of naloxone (family support organizations, police, security staff, and others). The program is open to essentially anyone interested in learning how to respond.
Through the program, naloxone is available without an individual prescription and at no cost to the client. To date, over 40,000 naloxone nasal sprays have been distributed.
At present, the program is expanding the platforms by which training and information are available to reach a broader group of people at risk of overdosing. This includes a staff e-learning course, an overdose prevention app, and videos to use during client training.
The Norwegian Centre for Addiction Research (SERAF) was commissioned to implement, coordinate, and evaluate the Take Home Naloxone Program. SERAF periodically publishes findings from the program. In addition to researchers from SERAF, the take-home naloxone team consists of three local coordinators.
Selected publications
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Ericson, Ø. B., Eide, D., Lobmaier, P., & Clausen, T. (2024). Mortality risk and causes of death among people who use opioids in a take-home naloxone cohort. Drug and Alcohol Dependence, 111087. doi:https://doi.org/10.1016/j.drugalcdep.2024.111087 |
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McDonald R, Eide D, Abel-Ollo K, Barnsdale L, Carter B, Clausen T, Day E, Fonseca F, Holmén E, Horsburgh K, Kelleher M, Kåberg M, Ladenhauf M, McAuley A, Metrebian N, Neale J, Parkin S, Ratcliffe K, Rintoul C, Smith J, Stifanoviciute V, Torrens M, Thiesen H, Strang J. A rapid assessment of take-home naloxone provision during COVID-19 in Europe. Int J Drug Policy. 2022 Sep;107:103787. doi:https://doi.org/10.1016/j.drugpo.2022.103787. Epub 2022 Jul 1. PMID: 35849935; PMCID: PMC9247228. |
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Eide, D., Lobmaier, P. & Clausen, T. Who is using take-home naloxone? An examination of supersavers. Harm Reduct J 19, 65 (2022). https://doi.org/10.1186/s12954-022-00647-z |
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Ericson, Ø.B., Eide, D., Lobmaier, P. et al. Staff preferences towards electronic data collection from a national take-home naloxone program: a cross-sectional study. Subst Abuse Treat Prev Policy 17, 13 (2022). https://doi.org/10.1186/s13011-022-00440-y |
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Ericson ØB, Eide D, Lobmaier P, Clausen T. Risks and overdose responses: Participant characteristics from the first seven years of a national take-home naloxone program. Drug Alcohol Depend. 2022 Nov 1;240:109645. doi:doi.org/10.1016/j.drugalcdep.2022.109645. Epub 2022 Sep 27. PMID: 36191532. |
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McDonald R, Parkin S, Eide D, Neale J, Clausen T, Metrebian N, Carter B, Strang J. Rethinking 'carriage' of take-home naloxone. Int J Drug Policy. 2021 Sep;95:103253. doi: 10.1016/j.drugpo.2021.103253. Epub 2021 Apr 11. PMID: 33848942. |
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Madah-Amiri D, Gjersing L, Clausen T. Naloxone distribution and possession following a large-scale naloxone programme. Addiction. 2019 Jan;114(1):92-100. doi: 10.1111/add.14425. Epub 2018 Sep 14. PMID: 30129078; PMCID: PMC6585734. |
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Petterson AG, Madah-Amiri D. Overdose prevention training with naloxone distribution in a prison in Oslo, Norway: a preliminary study. Harm Reduct J. 2017 Nov 21;14(1):74. doi: 10.1186/s12954-017-0200-z. PMID: 29162122; PMCID: PMC5696738. |
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Madah-Amiri D, Clausen T, Lobmaier P. Rapid widespread distribution of intranasal naloxone for overdose prevention. Drug Alcohol Depend. 2017 Apr 1;173:17-23. doi: 10.1016/j.drugalcdep.2016.12.013. Epub 2017 Jan 28. PMID: 28182982. |
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Madah-Amiri D, Clausen T. The use of public health infrastructure probably the best strategy for national and large-scale naloxone distribution programmes. Addiction. 2016 Jul;111(7):1309-10. doi: 10.1111/add.13400. Epub 2016 May 3. PMID: 27145487. |
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Madah-Amiri D, Clausen T, Lobmaier P. Utilizing a train-the-trainer model for multi-site naloxone distribution programs. Drug Alcohol Depend. 2016 Jun 1;163:153-6. doi: 10.1016/j.drugalcdep.2016.04.007. Epub 2016 Apr 14. PMID: 27107847. |
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Lobmaier, P. P., and Clausen, T. (2016) Radical red tape reduction by government supported nasal naloxone: the Norwegian pilot project is innovative, safe and an important contribution to further development and dissemination of take-home naloxone. Addiction, 111: 586–587. doi: 10.1111/add.13261. |
For more information, contact:
Philipp Lobmaier MD, PhD
Project Leader
Norwegian Centre for Addiction Research
+47 233 68 974
+47 95 30 79 19
p.p.lobmaier@medisin.uio.no
Desiree Eide PhD
Project Leader
Norwegian Centre for Addiction Research and King's College, London
Desiree.Eide@medisin.uio.no