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Peer-reviewedCC BY-NC-ND 4.0Health Policy and Technology

An impact evaluation of the Scottish take-home naloxone programme

Abstract

To describe the change in opioid-related deaths (ORDs) recorded across Scotland since National ‘Take Home’ Naloxone Programme (NNP) implementation between baseline pre-implementation (2006 – 2010) and 10-year post implementation (2011 – 2020) periods. To describe and contextualise the change in ORDs within 4 weeks of prison release and hospital discharge across the same pre- and post-implementation periods and evaluate the reach of naloxone to people at risk of opioid overdose during this period. Descriptive statistics as part of a pre-post secondary contribution analysis approach. The Better Evaluation Rainbow Framework for impact evaluation was utilised and data was obtained from official statistics and monitoring reports via Public Health Scotland. An increase in total ORDs nationwide was observed post-NNP implementation. In 2006–10, 9·8 % of ORDs (193 of 1970) were in people released from prison within 4 weeks of death, whereas only 4·4 % of ORDs (281 of 6439) in 2011–20 followed prison release, representing a 55 % reduction. A similar reduction in ORDs following hospital discharge was not observed. Cumulative reach of take-home naloxone to individuals at risk of opioid overdose across the post-implementation period was 58 %. Implementation of the Scottish NNP has coincided with an increase in total ORDs nationwide, increased availability of take-home naloxone for management of opioid overdose and a reduction in the proportion of opioid-related fatalities among recently released prisoners. Unfortunately, the proportion ORDs after hospital discharge remain unchanged suggesting that this population may benefit from further research and additional distribution approaches.

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BibTeX
@article{adams2026impact,
  title = {{An impact evaluation of the Scottish take-home naloxone programme}},
  author = {Tobias Joseph Adams and Joseph Tay Wee Teck and Alexander Baldacchino and Patrice Forget},
  journal = {Health Policy and Technology},
  year = {2026},
  month = oct,
  doi = {10.1016/j.hlpt.2025.101072},
  url = {https://hal.science/hal-05805412v1},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - An impact evaluation of the Scottish take-home naloxone programme
AU  - Tobias Joseph Adams
AU  - Joseph Tay Wee Teck
AU  - Alexander Baldacchino
AU  - Patrice Forget
PY  - 2026
DA  - 2026/10/19
JO  - Health Policy and Technology
DO  - 10.1016/j.hlpt.2025.101072
UR  - https://hal.science/hal-05805412v1
AB  - To describe the change in opioid-related deaths (ORDs) recorded across Scotland since National ‘Take Home’ Naloxone Programme (NNP) implementation between baseline pre-implementation (2006 – 2010) and 10-year post implementation (2011 – 2020) periods. To describe and contextualise the change in ORDs within 4 weeks of prison release and hospital discharge across the same pre- and post-implementation periods and evaluate the reach of naloxone to people at risk of opioid overdose during this period. Descriptive statistics as part of a pre-post secondary contribution analysis approach. The Better Evaluation Rainbow Framework for impact evaluation was utilised and data was obtained from official statistics and monitoring reports via Public Health Scotland. An increase in total ORDs nationwide was observed post-NNP implementation. In 2006–10, 9·8 % of ORDs (193 of 1970) were in people released from prison within 4 weeks of death, whereas only 4·4 % of ORDs (281 of 6439) in 2011–20 followed prison release, representing a 55 % reduction. A similar reduction in ORDs following hospital discharge was not observed. Cumulative reach of take-home naloxone to individuals at risk of opioid overdose across the post-implementation period was 58 %. Implementation of the Scottish NNP has coincided with an increase in total ORDs nationwide, increased availability of take-home naloxone for management of opioid overdose and a reduction in the proportion of opioid-related fatalities among recently released prisoners. Unfortunately, the proportion ORDs after hospital discharge remain unchanged suggesting that this population may benefit from further research and additional distribution approaches.
SN  - 2211-8837
ER  -