King's College London

Research portal

A rapid assessment of take-home naloxone provision during COVID-19 in Europe

Research output: Contribution to journalArticlepeer-review

Rebecca McDonald, Desiree Eide, Katri Abel-Ollo, Lee Barnsdale, Ben Carter, Thomas Clausen, Ed Day, Francina Fonseca, Elin Holmen, Kirsten Horsburgh, Michael Kelleher, Mike Kaberg, Martin Ladenhauf, Andrew McAuley, Nicola Metrebian, Joanne Neale, Stephen Parkin, Kevin Ratcliffe, Chris Rintoul, Josie Smith & 4 more Viktorija Stifanoviciute, Marta Torrens, Henrik Thiesen, John Strang

Original languageEnglish
Article number103787
JournalInternational Journal of Drug Policy
Early online date16 Jul 2022
Accepted/In press28 Jun 2022
E-pub ahead of print16 Jul 2022
PublishedSep 2022

Bibliographical note

Funding Information: Mike Kelleher: MK, in the past 3 years, has taken part in research funded by Indivior, Camurus and Mundipharma. He has received honoraria from Indivior, Gilead, and Abbvie. Funding Information: Martin Kåberg: MKå has received honoraria for lectures/consultancy from Abbvie, Gilead, MSD, Mundipharma, DnE Pharma, and Nordic Drugs and has received research grants from Gilead and Nordic Drugs. Funding Information: Stephen Parkin: SP has received funding, as part of his employment within King's College London, funding from Mundipharma Research Ltd, and Camurus AB pharmaceutical company and The Pilgrim Trust. SP was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London. Funding Information: Nicola Metrebian: NM has received, through her university, King's College London, research funding from Mundipharma Research Ltd (a pharmaceutical company that produces a naloxone nasal spray). She has also received, through her university, consultancy payment from an agency for Mayne Pharma International, on another area of research not relevant to the article under consideration. Funding Information: Joanne Neale: JN has received, through her university, research funding from Mundipharma Research Ltd and Camurus AB for unrelated research and an honorarium from Indivior for an unrelated conference presentation. JN was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London. Publisher Copyright: © 2022 The Author(s)


King's Authors


In March 2020, the World Health Organization declared COVID-19 a global pandemic. In the following weeks, most European countries implemented national lockdowns to mitigate viral spread. Services for people who use drugs had to quickly revise their operating procedures to rearrange service provision while adhering to lockdown requirements. Given the scarcity of literature published on overdose prevention during COVID-19 in Europe, we aimed to examine how these changes to service provision affected take-home naloxone (THN) programmes and naloxone availability across Europe.

Between November 2020 and January 2021, we conducted a rapid assessment with country experts from European countries that provide THN. We sent country experts a template to report monthly THN distribution data (January 1, 2019-October 31, 2020) and a structured 6-item survey for completion.

Responses were received from 14 of the 15 European countries with THN provision of which 11 participated in the rapid assessment: Austria, Denmark, England, Estonia, Lithuania, Northern Ireland, Norway, Scotland, Spain (Catalonia only), Sweden, and Wales. All reported reduced organisational capacity during COVID-19, and some put into place a range of novel approaches to manage the restrictions on face-to-face service provision. In six countries, the introduction of programme innovation occurred alongside the publication of government guidelines recommending increased THN provision during COVID-19. Eight of the eleven participating countries managed to maintain 2019-level monthly THN distribution rates or even increase provision during the pandemic.

Through programme innovation supported by public guidelines, many European THN programmes managed to ensure stable or even increased THN provision during the pandemic, despite social distancing and stay-at-home orders affecting client mobility.

Download statistics

No data available

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454