The THN programs worldwide
Take-home naloxone programs in Europe
In 2020, national, regional or local THN programmes were implemented in 10 EU countries, Norway and the UK.
Source: https://www.emcdda.europa.eu/publications/topic-overviews/take-home-naloxone_en#section5
Naloxone distribution initiatives were reported to exist in 12 countries: Austria, Denmark, Estonia, France, Germany, Ireland, Italy, Lithuania, Norway, Spain (Catalonia), Sweden and the United Kingdom. In 2018, the legal framework for establishing such programmes had been created in Cyprus and preparatory steps for introducing naloxone were taken in Finland.
For more information, visit this page: https://www.emcdda.europa.eu/publications/topic-overviews/take-home-naloxone_en#section5
Take-home naloxone programs in USA
Naloxone in the US is available nationwide. However, there are differences between states. The best availability is in Wyoming, Arkansas, New Mexico, Rhode Island, and Kentucky. The least in Georgia, Iowa, Minnesota, New Hampshire, South Dakota, and Texas [^1].
Take-home naloxone programs in LIMIC country
According to data from the Harm Reduction International Report [^2], naloxone is available in 2023 in 14 LIMICs, but only half of them run a peer distritbution naloxone programme. These include: Georgia, Kyrgyzstan, Tajikistan, Myanmar, Kenya, Colombia, Mexico and Puerto Rico.
The barriers implementig THN programs worldwide
The main barriers to THN strategies were the lack of training of healthcare providers, lack of privileges, time constraints, cost, legislative/policy restrictions, stigma, fear of litigation, and some misperceptions around THN.
The barriers are probably apply mainly to LMIC, but more difficult to overcome considering the differences in their response to opioid overdose, their cultural attitudes and norms, the high cost, the waivers required, the legislative differences and the severe penalties for drug-related offenses in some of these countries [^3].
Country example: Ukraine, Kazakhstan, Kyrgyzstan and Tajikistan
In 2019 the United Nations Office on Drugs and Crime (UNODC) is funding the ‘S-O-S’ initiative (Stop Overdose Safely) that started THN implementation in Ukraine, Kazakhstan, Kyrgyzstan and Tajikistan. The project resulted in the rapid distribution of THN; 14263 potential opioid overdose witnesses were trained within the eight-month implementation phase. The study found that 90% of project participants reported using naloxone at witnessed overdoses across almost all countries (88.1% in Ukraine). In almost all instances it was recorded that the victim survived.
- Centers for Disease Control and Prevention. State Unintentional Drug Overdose Reporting System (SUDORS). Final Data. Atlanta, GA: US Department of Health and Human Services, CDC.
- Harm Reduction International, (2024), Global State of Harm Reduction 2024, HRI, London.
- Sajwani, H.S., Williams, A.V. A systematic review of the distribution of take-home naloxone in low- and middle-income countries and barriers to the implementation of take-home naloxone programs. Harm Reduct J 19, 117 (2022).