The Norwegian naloxone program
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 be available in most municipalities that experience opioid overdoses. The program continues to be part of the National Overdose Strategy.
Staff working in municipal facilities that serve people who use drugs are trained to distribute naloxone. Naloxone is primarily distributed via low-threshold facilities, but is also available at treatment centers, shelters, and prisons. 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 who is interested in learning how to respond. Take home naloxone is currently distributed in over 100 facilities and is available without an individual prescription and at no cost to the client. To date, over 10,000 naloxone nasal sprays have been distributed.
Given the many benefits of a nasal spray preparation, (reduced stigma; easier administration; reduced risk of transmission of HCV & HIV), Norway uses a nasal spray for the program. The program began with 2mg/2mL pre-filled syringes with a nasal atomizer, but in 2018 switched to Nyxoid 1.8mg single dose nasal sprays. The Norwegian University of Science and Technology (NTNU) is currently developing a 1.26mg single dose nasal spray (Ventizolve) that will be commercialized during 2020 (1).
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.
Publications from the program
Madah-Amiri D, Gjersing L, Clausen T. Naloxone distribution and possession following a large-scale naloxone programme. Addiction. 2019. https://onlinelibrary.wiley.com/doi/full/10.1111/add.14425
Petterson A, Madah-Amiri D. Overdose prevention training with naloxone distribution in a prison in Oslo, Norway: a preliminary study. Harm Reduct J. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696738/
Madah-Amiri D, Clausen T, Lobmaier P. Rapid widespread distribution of intranasal naloxone for overdose prevention. Drug Alcohol Depend. 2017. https://www.ncbi.nlm.nih.gov/pubmed/28182982
Madah-Amiri D, Clausen T, Lobmaier P. Utilizing the train-the-trainer model for multi-site naloxone distribution programs. Drug Alcohol Depend. 2016. https://www.ncbi.nlm.nih.gov/pubmed/27107847
For more information, contact:
Philipp Lobmaier MD, PhD
Norwegian Centre for Addiction Research
+47 233 68 974
+47 95 30 79 19
Desiree Eide PhD
Norwegian Centre for Addiction Research and King's College, London
Midling, AS. (2018.19.07). Nasal spray developed at NTNU promises to save lives in twelve countries. Retrieved from: https://norwegianscitechnews.com/2018/07/nasal-spray-developed-at-ntnu-promises-to-save-lives-in-twelve-countries/