Evidence map›Paper›PMID 27028542›Full record

SynthesisAddiction (Abingdon, England)2016

Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria.

Rebecca McDonald, John Strang

2 registry-linked trialsOpen access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Addiction (Abingdon, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 204 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
204citing papers in PubMed, 15 pooled it
35.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05358132 completednot on this mapstarted 2022, after this paper: background citation

ARM-ED: Advanced Respiratory Monitoring Events in Drug Toxicity - An Emergency Department Feasibility Study of the Utilisation of a Wearable Device in Patients With Sedative Effects of Drugs

TypeobservationalSponsorNHS Greater Glasgow and ClydeRan2022 to 2024Enrolled78ConditionsRespiratory Insufficiency, Overdose of Opiate, Sedative Overdose, Sedative ToxicityArmsPneumowave Device placement and data capture
NCT06843213 narecruitingnot on this mapstarted 2025, after this paper: background citation

Teaching Health Promotion and Resilience in Varied Environments: a Peer-led Intervention Following Hospital Discharge

TypeinterventionalSponsorUniversity of PennsylvaniaRan2025 to 2028Enrolled390ConditionsOpioid Use Disorder, Harm Reduction, Health PromotionArmsPeer Intervention, Enhanced Usual Care
3 · Its place in the literature

Who cites it

204 citing papers in PubMed, 15 syntheses or guidelines pooled it, 466 citations in OpenAlex.

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  13. The Relationship Between Exposure to Alcohol Marketing and Underage Drinking Is Causal.Journal of studies on alcohol and drugs. Supplement · 2020
    Pooled it
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  17. Take-home naloxone in multicentre emergency settings: the TIME feasibility cluster RCT.Health technology assessment (Winchester, England) · 2024
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144 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Rebecca McDonaldNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
John StrangNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
King's College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsFatal outcome of opioid overdose, once detected, is preventable through timely administration of the antidote naloxone. Take-home naloxone provision directly to opioid users for emergency use has been implemented recently in more than 15 countries worldwide, albeit mainly as pilot schemes and without formal evaluation. This systematic review assesses the effectiveness of take-home naloxone, with two specific aims: (1) to study the impact of take-home naloxone distribution on overdose-related mortality; and (2) to assess the safety of take-home naloxone in terms of adverse events.

methodsPubMed, MEDLINE and PsychINFO were searched for English-language peer-reviewed publications (randomized or observational trials) using the Boolean search query: (opioid OR opiate) AND overdose AND prevention. Evidence was evaluated using the nine Bradford Hill criteria for causation, devised to assess a potential causal relationship between public health interventions and clinical outcomes when only observational data are available.

resultsA total of 1397 records (1164 after removal of duplicates) were retrieved, with 22 observational studies meeting eligibility criteria. Due to variability in size and quality of the included studies, meta-analysis was dismissed in favour of narrative synthesis. From eligible studies, we found take-home naloxone met all nine Bradford Hill criteria. The additional five World Health Organization criteria were all either met partially (two) or fully (three). Even with take-home naloxone administration, fatal outcome was reported in one in 123 overdose cases (0.8%; 95% confidence interval = 0.4, 1.2).

conclusionsTake-home naloxone programmes are found to reduce overdose mortality among programme participants and in the community and have a low rate of adverse events.

Indexed as

Opioid-Related DisordersAnalgesics, OpioidDrug OverdoseHumansNaloxoneNarcotic AntagonistsAnalgesics, OpioidNaloxoneNarcotic AntagonistsBradford Hilldeathheroinnaloxoneopiateopioidoverdoseprevention

Identifiers

PMID27028542
PMCPMC5071734
OpenAlexW2331803526

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.