Publication Highlights

Concerns that take-home naloxone (THN) training may lead to riskier drug use, as a form of overdose risk compensation, remain a substantial barrier to training implementation.

However, there was limited good-quality evidence in a systematic review of the association between THN access and subsequent risk compensation behaviours.

This study, which used injecting frequency, opioid injecting frequency, benzodiazepine use frequency and proportion of time drugs were used alone as indicators of overdose risk, assessed whether THN training was associated with changes in overdose risk behaviours in a cohort of people who inject drugs.

It found no evidence of an increase in markers of overdose risk after THN training and supply. These findings, which are consistent with an emerging evidence base suggesting concerns about risk compensation with naloxone availability are unfounded, suggest THN training should not be withheld because of concerns about risk compensation and that advocacy for availability and uptake of THN is required to address unprecedented opioid-associated mortality.

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