K H Benjamin Leung, Brian E Grunau, May K Lee, Jane A Buxton, Jennie Helmer, Sean van Diepen, Jim Christenson, Timothy C Y Chan
Background: More than 85 000 people die annually across North America from opioid poisoning; naloxone in the hands of the public is an effective intervention and saves lives. We compared the accessibility of different placement strategies for public-access naloxone kits.
Methods: We evaluated all opioid-poisoning incidents recorded by BC Emergency Health Services between December 2014 and August 2020 in Metro Vancouver, Canada. We determined the number of opioid poisonings "covered" (i.e., within a 3-minute walk) by 3 different coverage strategies: (1) existing locations participating in take-home naloxone programs; (2) blanket naloxone kit placement at chain businesses, pharmacies, and registered public-defibrillator locations; and (3) optimization-based strategic kit placement at transit stops based on historical poisonings.
Results: We included 14 089 opioid poisonings. Existing locations participating in take-home naloxone programs (647 locations) covered 4988 (35.4%) opioid poisonings. Chain businesses (10-233 locations) covered 6 (0.0%) to 1165 (8.3%) opioid poisonings, and chain business categories (12-810 locations), pharmacies (790 locations), and public-defibrillator locations (980 locations) covered 97 (0.7%) to 3152 (22.4%) opioid poisonings. Optimization-based strategic placement of naloxone kits at transit stops yielded generally higher coverage levels, ranging from 2907 (20.6%) opioid poisonings covered with 10 kit locations, to 7506 (53.3%) with 1000 kit locations.
Interpretation: Optimized placement of publicly accessible naloxone kits at transit locations was most effective at improving public accessibility of naloxone, and blanket placement at take-home naloxone program locations covered a substantial proportion of opioid poisonings. Public-access naloxone may improve community access to naloxone in response to opioid poisonings.
{"title":"Optimizing placement of public-access naloxone kits using geospatial analytics: a modelling study.","authors":"K H Benjamin Leung, Brian E Grunau, May K Lee, Jane A Buxton, Jennie Helmer, Sean van Diepen, Jim Christenson, Timothy C Y Chan","doi":"10.1503/cmaj.241228","DOIUrl":"10.1503/cmaj.241228","url":null,"abstract":"<p><strong>Background: </strong>More than 85 000 people die annually across North America from opioid poisoning; naloxone in the hands of the public is an effective intervention and saves lives. We compared the accessibility of different placement strategies for public-access naloxone kits.</p><p><strong>Methods: </strong>We evaluated all opioid-poisoning incidents recorded by BC Emergency Health Services between December 2014 and August 2020 in Metro Vancouver, Canada. We determined the number of opioid poisonings \"covered\" (i.e., within a 3-minute walk) by 3 different coverage strategies: (1) existing locations participating in take-home naloxone programs; (2) blanket naloxone kit placement at chain businesses, pharmacies, and registered public-defibrillator locations; and (3) optimization-based strategic kit placement at transit stops based on historical poisonings.</p><p><strong>Results: </strong>We included 14 089 opioid poisonings. Existing locations participating in take-home naloxone programs (647 locations) covered 4988 (35.4%) opioid poisonings. Chain businesses (10-233 locations) covered 6 (0.0%) to 1165 (8.3%) opioid poisonings, and chain business categories (12-810 locations), pharmacies (790 locations), and public-defibrillator locations (980 locations) covered 97 (0.7%) to 3152 (22.4%) opioid poisonings. Optimization-based strategic placement of naloxone kits at transit stops yielded generally higher coverage levels, ranging from 2907 (20.6%) opioid poisonings covered with 10 kit locations, to 7506 (53.3%) with 1000 kit locations.</p><p><strong>Interpretation: </strong>Optimized placement of publicly accessible naloxone kits at transit locations was most effective at improving public accessibility of naloxone, and blanket placement at take-home naloxone program locations covered a substantial proportion of opioid poisonings. Public-access naloxone may improve community access to naloxone in response to opioid poisonings.</p>","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E258-E265"},"PeriodicalIF":9.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benoit Lafleur, Manuel Montero-Odasso, Shirley Huang
{"title":"Falls in older adults.","authors":"Benoit Lafleur, Manuel Montero-Odasso, Shirley Huang","doi":"10.1503/cmaj.241702","DOIUrl":"10.1503/cmaj.241702","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E271"},"PeriodicalIF":9.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel Czikk, George Elzawy, Prasad Jetty, Jennifer Leppard
{"title":"Popliteal artery entrapment syndrome in a 20-year-old man.","authors":"Daniel Czikk, George Elzawy, Prasad Jetty, Jennifer Leppard","doi":"10.1503/cmaj.241083","DOIUrl":"10.1503/cmaj.241083","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E266-E270"},"PeriodicalIF":9.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin Sellier Silva, Irnes Zeljkovic, Lena Palaniyappan
{"title":"Students in mental health crisis.","authors":"Martin Sellier Silva, Irnes Zeljkovic, Lena Palaniyappan","doi":"10.1503/cmaj.241439","DOIUrl":"10.1503/cmaj.241439","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E272"},"PeriodicalIF":9.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"March 2025 obituaries.","authors":"","doi":"10.1503/cmaj.250342","DOIUrl":"https://doi.org/10.1503/cmaj.250342","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E273-E275"},"PeriodicalIF":9.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fardeau des décès par surdose au sein des populations carcérales : implications pour les interventions.","authors":"Benedikt Fischer, Elnaz Moghimi, John Weekes","doi":"10.1503/cmaj.241661-f","DOIUrl":"10.1503/cmaj.241661-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E283-E285"},"PeriodicalIF":9.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bension Tilley, Valerie S Kim, Elliot Lass, Mario Masellis, William K Silverstein
{"title":"Rhombencéphalite chez une femme de 86 ans atteinte de leucémie lymphoïde chronique.","authors":"Bension Tilley, Valerie S Kim, Elliot Lass, Mario Masellis, William K Silverstein","doi":"10.1503/cmaj.241071-f","DOIUrl":"10.1503/cmaj.241071-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 10","pages":"E276-E280"},"PeriodicalIF":9.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Agonistes du récepteur du peptide-1 de type glucagon durant la grossesse et l’allaitement.","authors":"Jonathan S Zipursky, Tali Bogler, Cynthia Maxwell","doi":"10.1503/cmaj.240768-f","DOIUrl":"10.1503/cmaj.240768-f","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 9","pages":"E254-E255"},"PeriodicalIF":9.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oropouche virus.","authors":"Tri Dinh, Jamil Kanji, Stephen Vaughan","doi":"10.1503/cmaj.241440","DOIUrl":"10.1503/cmaj.241440","url":null,"abstract":"","PeriodicalId":9609,"journal":{"name":"Canadian Medical Association journal","volume":"197 9","pages":"E244"},"PeriodicalIF":9.4,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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