New trial of naloxone nasal spray in Norway

First published: March 29, 2019 | Last updated: May 20th, 2019

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Professor Thomas Clausen

Professor, Dr. med

Thomas Clausen is a professor at the University of Oslo, SERAF, Norwegian Centre for Addiction Research and Institute of Clinical Medicine.

Thomas Clausen is an MD PhD, with research focused towards opioid dependence, overdose prevention and treatment outcomes in the field of addiction medicine. Also other addiction related topics are included in the publication list, including 12-step facilitation, compulsory treatment, physical activity as part of addiction treatment, alcohol epidemiology in low-and middle income countres etc. He has a current appointment as a National Expert to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) for Norway, and an ongoing collaboration with the WHO to investigate alcohol use and health outcomes particularly in low-and middle income countries.

During the academic year of 2014-15 Professor Clausen is a visiting Fulbright Scholar at the Alcohol Research Group (ARG), in Emeryville, California.



New trial of intranasal naloxone in Norway

Thomas Clausen, Professor MD PhD, Philipp Lobmaier, MD PhD, Desiree Madah-Amiri, NP, PhD student

Norwegian Centre for Addiction Research (SERAF), University of Oslo, Norway

Introduction

Norway has experienced high rates of opioid overdose deaths since the 1990s. Consequently the government introduced a national overdose prevention strategy in 2014. The distribution of intranasal naloxone to drug users and peers was part of the strategy as a new intervention.

Methods

A pilot project in the two largest cities; Oslo and Bergen with distribution of intranasal naloxone has been established.

Intranasal naloxone (2mg/2ml prefilled syringes) is provided after attending a brief rescue/intervention/prevention course. Distribution was initially focused towards existing low threshold facilities, but is now mainstreamed into a range of available treatment settings as well as upon prison release.

Experiences from implementation and preliminary results are to be presented.

Results

Distribution through existing service centres and treatment facilities yielded rapid distribution. During the first 10 months, more than 400 staff were trained to be trainers. More than 1000 nasal sprays were distributed, of these 240 naloxone refills. Successfully naloxone reversals were reported in more than 90 % of uses, from those requesting refill.

Conclusion

The distribution of intranasal naloxone through cooperation with existing low-threshold facilities and treatment facilities were crucial for rapid dissemination. Rates suggested as appropriate “saturation” rates of kits distribution into the target population was achieved during the first year of the project. The governmental support for the intervention through the national prevention strategy and provision of funding was key to its rapid high volume distribution.

Funding for the National overdose strategy, the intranasal naloxone kits and the evaluation of the intervention was provided by the Norwegian Directorate of Health.

No conflicts of interest.

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Professor Thomas Clausen