| dc.description.abstract | Aim: To investigate whether higher doses of peer-administered intranasal naloxone used for reversal of opioid overdose predict a.) more withdrawal symptoms, or b.) more frequent ambulance transport than lower doses. Design: Quantitative survey study from a prospective longitudinal study within the Norwegian nasal naloxone-project. Setting: Naloxone distribution sites in Oslo and Bergen. Data was collected between March and December 2015. Participants: 236 receivers of intranasal naloxone who came back for replenishment and reported using the first spray for overdose reversal. Participants were mostly people who inject drugs (PWID). Measurements: Self-reported dose of intranasal naloxone used in overdose reversal, observed withdrawal symptoms, victim outcome, and ambulance transport. Findings: Doses seem to be titrated as instructed, with 33% (n=68) reporting 2 doses and 28% (n=58) giving the whole spray. 98% (n=208) reported successful reversal of the overdose and more than one-third reported ambulance transport (n=72). One third of cases (n=72) reported no withdrawal symptoms, while 43% (n=90) reported one or more symptoms. The most frequently reported symptoms were confusion in 25% of cases (n=43) and anger in 16% of cases (n=27). No significant difference was found in the reporting of withdrawal symptoms (risk ratio (RR): 0,85, 95% confidence interval (CI): 0,64-1,12), presence of multiple symptoms (RR: 0,68, 95% CI: 0,33- 1,39), or ambulance transport (RR: 0,92, 95% CI: 0,67-1,26) between those who received a high dose versus a low dose. No significant difference was found in ambulance transport between those who reported symptoms and those who did not (RR: 0,95, 95% CI: 0,69-1,30). Conclusions: Participants seem to titrate the intranasal naloxone correctly and higher doses do not predict more withdrawal symptoms or more frequent ambulance transport. High rates of confusion and anger were seen. | eng |