BACKGROUND Naloxone is a safe and effective medication to help reverse opioid overdose. Providing take-home naloxone to patients in opioid treatment settings is a critical step to reducing opioid overdose deaths. In New Mexico, a US state with one of the highest rates of opioid overdose deaths, legislation was passed in 2017 (House Bill 370) to support take-home naloxone, and followed by naloxone training of Opioid Treatment Program staff to increase distribution. METHODS Naloxone training was offered to all New Mexico Opioid Treatment Programs along with a baseline survey to assess current practices and barriers to take-home naloxone distribution. Focus groups were conducted approximately 1 year post-training with staff at a subset of the trained Opioid Treatment Programs to assess the impact of the legislation and training provided. RESULTS Baseline survey results show most Opioid Treatment Program staff were unfamiliar with House Bill 370, reported conflicting understandings of their agency's current take-home naloxone practices, and reported a number of barriers at the patient, agency, and policy level. Follow-up focus groups revealed support for House Bill 370 but persistent barriers to its implementation at the patient, agency, and policy level including patient receptivity, cost of naloxone, staff time, and prohibitive pharmacy board regulations. CONCLUSIONS In spite of targeted legislation and training, provision of take-home naloxone at remained low. This is alarming given the need for this lifesaving medication among the Opioid Treatment Program patient population, and high opioid death rate in New Mexico. Locally, important next steps include clarifying regulatory guidelines and supporting policy/billing changes to offset costs to Opioid Treatment Programs. Globally, additional research is needed to identify the prevalence of take-home naloxone distribution in similar settings, common barriers, and best practices that can be shared to increase access to this vital lifesaving medication in this critical context.

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带回家纳洛酮分发的障碍和建议：新墨西哥州阿片类药物治疗计划的观点。

背景技术纳洛酮是帮助逆转阿片类药物过量的安全有效药物。为处于阿片类药物治疗环境的患者提供带回家的纳洛酮是减少阿片类药物过量死亡的关键步骤。在美国阿片类药物过量死亡率最高的州之一的新墨西哥州，2017年通过了立法（众议院370号法案），以支持带回家的纳洛酮，随后对纳洛酮培训了阿片类药物治疗计划的工作人员，以增加分发量。方法将纳洛酮培训提供给所有新墨西哥阿片类药物治疗计划以及基线调查，以评估目前的做法和带回家纳洛酮分发的障碍。在培训后约一年的时间里，与一组受过培训的阿片类药物治疗计划的工作人员一起开展了焦点小组会议，以评估立法和所提供培训的影响。结果基线调查结果表明，大多数阿片类药物治疗计划的工作人员都不熟悉370号众议院法案，他们对其机构目前的实得纳洛酮做法的理解相互矛盾，并报告了患者，机构和政策层面的许多障碍。后续焦点小组表示支持众议院第370号法案，但在患者，机构和政策层面实施该法案存在持续障碍，包括患者的接受性，纳洛酮成本，工作人员时间以及药房委员会的禁止性规定。结论尽管有针对性的立法和培训，但带回家纳洛酮的供应仍然很低。鉴于在阿片类药物治疗计划患者人群中需要这种救生药物，而且在新墨西哥州，阿片类药物的死亡率很高，这令人震惊。在本地 下一步的重要步骤包括阐明监管指南，并支持政策/计费更改以抵消阿片类药物治疗计划的费用。在全球范围内，还需要进行其他研究来确定在类似情况，常见障碍和最佳实践中可以带回家的纳洛酮分布的普遍性，这些共享经验可以共享以增加在这种关键情况下使用这种重要的救生药物的机会。