TY - JOUR A1 - Fleißner, Simon A1 - Stöver, Heino A1 - Schäffer, Dirk A1 - Wodarz-von Essen, Heike A1 - Deimel, Daniel A1 - Wodarz, Norbert T1 - Take-home naloxone in opioid dependency JF - Deutsches Ärzteblatt international N2 - Background: There were 2227 drug-related deaths in Germany in 2023, corresponding to a rise of 12% over the previous year and a doubling over the course of a decade. Approximately 60% of these deaths were related to opioid consumption. In this narrative review, we discuss whether take-home naloxone (THN) might lower the mortality of persons with opioid dependency. Methods: This review is based on pertinent publications that were retrieved by a selective search in PubMed. Results: Seven observational studies of the mortality of persons with opioid dependency were included in the analysis. The available evidence for the intervention is on a low level. The studies indicate an overall lowering of mortality even though a significant reduction in drug-related deaths was not always achieved. It was concluded in a meta-analysis of 9 observational studies that 9.2% (95% confidence interval, [5.2; 13.1]) of the THN kits provided were actually used in the first three months to prevent opioid overdose–related death. In a Canadian study, 43% [41; 45] of the naloxone kits that were handed out over a period of 8 years were used and successfully prevented opioid overdose-related death. The latter figures suggest that the use of THN may have been systematically underestimated to date. Conclusion: Demonstrating the efficacy of THN is difficult because of the nature of the research topic. Current evidence implies that THN lowers the mortality of persons with opioid dependence. It is estimated that only about 1.3% of opioid dependent people have been provided with THN in Germany thus far. A major expansion of the provision and use of THN could contribute to a further reduction in opioid-related deaths. Cite this as: Fleissner S, Stöver H, Schäffer D, Wodarz-von Essen H, Deimel D, Wodarz N: Take-home naloxone in opioid dependency: An intervention to reduce opioid-related deaths. Y1 - 2025 U6 - https://doi.org/10.3238/arztebl.m2025.0030 SN - 1866-0452 IS - 122 SP - 240 EP - 244 PB - Deutscher Arzte-Verlag GmbH ER - TY - JOUR A1 - Fleißner, Simon A1 - Steimle, Larissa A1 - Schäffer, Dirk A1 - Werse, Bernd A1 - Deimel, Daniel A1 - Kuban, Maria A1 - Stöver, Heino T1 - The implementation of take-home naloxone: Lessons learned from a 3-year take-home naloxone project in Germany JF - Harm Reduction Journal N2 - Background Take-home naloxone (THN) can prevent deaths related to opioid overdoses. Despite the first THN project in Germany in 1998, the availability of naloxone for people who use opioids (PWUO) is still scarce. We present the results of the German-wide THN-project NALtrain, which aimed to implement THN nationwide. Firstly, we present data collected during NALtrain and secondly, we use this data to critically reflect on the project and thereby draw conclusions that could inform future THN projects. Method NALtrain was conducted between July 2021 and June 2024. Descriptive statistical analysis of the documentation of 74 train-the-trainer events and following naloxone trainings conducted by the trained staff were carried out. Results 864 staff members from approximately 373 organizations (mainly harm reduction services) participated in 74 train-the-trainer courses. Of the 373 organizations 123 conducted 784 naloxone trainings for PWUO and reached 2,333 PWUO, of whom 1,451 received THN. The goal of training 800 staff members was met, while the goals of reaching 400 organizations and 10,000 PWUO were missed. The implementation of THN is unevenly distributed across the German federal states, especially concentrated in Bavaria. The core learnings are that the prescription-only status of THN leads to extra organizational efforts and hinders the availability of THN for individuals with the highest risk of overdose. Conclusion Considering the proportion of organizations offering THN, they can still be classified as “early adopters”. These may serve as role models for the broader majority. Free available THN and centrally coordinated support of implementation including recurring follow-up can be key to a broader availability of THN in Germany. In future initiatives physicians and medical settings should be prioritized. Y1 - 2025 U6 - https://doi.org/10.1186/s12954-025-01281-1 SN - 1477-7517 VL - 22 IS - 1 PB - Springer Science and Business Media LLC ER -