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Optimizing placement of public-access naloxone kits using geospatial analytics: a modelling study.

K H Benjamin Leung1, Brian E Grunau2, May K Lee2

  • 1Department of Mechanical & Industrial Engineering (Leung, Chan), University of Toronto, Toronto, Ont.; Duke Clinical Research Institute (Leung), Duke University, Durham, NC; Department of Emergency Medicine (Grunau, Christenson), University of British Columbia; Centre for Advancing Health Outcomes (Grunau, Lee, Christenson), St. Paul's Hospital; School of Population and Public Health (Buxton, Helmer), University of British Columbia; British Columbia Emergency Health Services (Helmer), Vancouver, BC; Division of Cardiology (van Diepen), Department of Medicine, and Department of Critical Care Medicine (van Diepen), University of Alberta, Edmonton, Alta.; Li Ka Shing Knowledge Institute (Chan), St. Michael's Hospital, Toronto, Ont. benjamin.leung@duke.edu.

CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
|March 17, 2025
PubMed
Summary

Optimized placement of naloxone kits at transit stops is most effective for public access during opioid emergencies. This strategy significantly increases the number of opioid poisoning incidents covered by readily available naloxone.

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Area of Science:

  • Public Health
  • Emergency Medicine
  • Pharmaceutics

Background:

  • Over 85,000 annual deaths from opioid poisoning in North America highlight the need for accessible interventions.
  • Publicly available naloxone (an opioid overdose reversal medication) is a proven life-saving intervention.
  • Comparing different public-access naloxone kit placement strategies is crucial for maximizing effectiveness.

Purpose of the Study:

  • To compare the accessibility of naloxone kits across various public placement strategies.
  • To determine which placement strategy offers the greatest coverage for opioid poisoning incidents.

Main Methods:

  • Analysis of 14,089 opioid poisoning incidents in Metro Vancouver (December 2014–August 2020).
  • Evaluation of three naloxone kit coverage strategies: existing take-home naloxone program sites, blanket placement (chain businesses, pharmacies, defibrillator locations), and optimized transit stop placement.
  • Assessment of coverage based on a 3-minute walk to a naloxone kit.

Main Results:

  • Existing take-home naloxone programs covered 35.4% of incidents.
  • Blanket placement strategies covered between 0.7% and 22.4% of incidents, depending on location type and number.
  • Optimized placement at transit stops showed superior coverage, with 1000 kits covering up to 53.3% of incidents.

Conclusions:

  • Optimized strategic placement of naloxone kits at transit locations is the most effective method for enhancing public access.
  • Public-access naloxone, particularly when strategically placed, can significantly improve community response to opioid poisonings.
  • Blanket placement at existing take-home naloxone program sites also covers a substantial number of opioid poisoning events.