Evaluation of a large-scale health department naloxone distribution program: Per capita naloxone distribution and overdose morality
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Updated: Jul 19, 2025

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Published on: June 10, 2013
Caroline E Freiermuth1,2, Rachel M Ancona3, Jennifer L Brown4
1Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America.
Objectives:
To report per-capita distribution of take-home naloxone to lay bystanders and evaluate changes in opioid overdose mortality in the county over time.
Methods:
Hamilton County Public Health in southwestern Ohio led the program from Oct 2017-Dec 2019. Analyses included all cartons distributed within Hamilton County or in surrounding counties to people who reported a home address within Hamilton County. Per capita distribution was estimated using publicly available census data. Opioid overdose mortality was compared between the period before (Oct 2015-Sep 2017) and during (Oct 2017-Sep 2019) the program.
Results:
A total of 10,416 cartons were included for analyses, with a total per capita distribution of 1,275 cartons per 100,000 county residents (average annual rate of 588/100,000). Median monthly opioid overdose mortality in the two years before (28 persons, 95% CI 25-31) and during (26, 95% CI 23-28) the program did not differ significantly.
Conclusions:
Massive and rapid naloxone distribution to lay bystanders is feasible. Even large-scale take-home naloxone distribution may not substantially reduce opioid overdose mortality rates.
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