Take-Home Naloxone for People who use Opioids: A Contribution to Reducing Drug-Related Deaths – Current Situation in Germany

Abstract: Background: Drug-related deaths associated with opioids are the leading cause of death related to illicit substances. Take-Home Naloxone (THN) as a nasal spray for people who use opioids (PWUO) could prevent fatalities. However, it has not yet been widely implemented in Germany. This article consolidates findings from the two pilot projects, BayTHN and NALtrain, to provide an overview of THN in Germany and formulates recommendations for its broader implementation. Method: Since 2018 within two observational studies, initially with BayTHN and additionally with NALtrain from 2021 onwards, PWUO have received standardized overdose education followed by access to THN. Results: Across both projects, 1020 staff members were trained to provide THN. With additionally 595 PWUO documented by the Bavarian State Ministry of Health, Care and Prevention (StMGP) at least 2,664 PWUO were reached with THN (1.6 % of PWUO in Germany), and 203 THN administrations were documented. Conclusion: For THN to reach its full harm reduction potential, at least 30 % of PWUO (50,000 PWUO) should be reached. THN has already been successfully implemented in various settings in Germany, but not nationwide. The reluctance of physicians to prescribe THN and the lack of funding for overdose education and THN in most federal states remain key barriers to a broader implementation.