References

Public sources behind the service approach

These sources are included so project partners, reviewers, and members of the public can see the public-health basis for a simple Oregon mail-order naloxone request path.

Naloxone basics and public access

FDA: FDA Approves First Over-the-Counter Naloxone Nasal Spray FDA announcement from March 29, 2023, approving Narcan 4 mg naloxone hydrochloride nasal spray for over-the-counter, nonprescription use.
FDA: Access to Naloxone Can Save a Life During an Opioid Overdose Consumer-facing FDA overview of naloxone as an overdose reversal medication and the role of access during an opioid overdose.
FDA: Information About Naloxone and Nalmefene FDA drug safety page noting naloxone’s community-use role, noncontrolled status, and lack of abuse potential.
CDC: Lifesaving Naloxone CDC overview of naloxone safety, over-the-counter access, bystander response, and the importance of having naloxone available before an emergency.
CDC: 5 Things to Know About Naloxone Plain-language CDC overview of naloxone, opioid overdose response, and why carrying naloxone can help bystanders act quickly.
NIDA: Naloxone DrugFacts National Institute on Drug Abuse summary of naloxone formulations, use, and safety.
Oregon Health Authority: Opioid Overdose Reversal Medications Oregon-specific overview of naloxone and overdose reversal medication access, including Oregon pharmacy access pathways.
Oregon Health Authority: Statewide Standing Order to Dispense Naloxone Oregon standing order supporting access to naloxone through eligible Oregon people and entities.

Distribution and mail-based access

Yang, Favaro, and Meacham: NEXT Harm Reduction, American Journal of Public Health, 2021 Peer-reviewed description of an online, mail-based naloxone and harm-reduction distribution program, including privacy considerations for participant information.
Pacheco et al.: Mail-order overdose education and naloxone distribution, Harm Reduction Journal, 2024 Study of a mail-order overdose education and naloxone distribution program, including how different access points reached different groups.
Walley et al.: Opioid overdose rates and overdose education and nasal naloxone distribution in Massachusetts, BMJ, 2013 Population-level study of overdose education and nasal naloxone distribution implementation in Massachusetts communities.
The Effect of Overdose Education and Naloxone Distribution: An Umbrella Review of Systematic Reviews Review of systematic reviews on overdose education and naloxone distribution, including evidence and limits of current research.
Effectiveness of naloxone distribution in community settings: systematic review and meta-analysis Review and meta-analysis of community naloxone distribution settings and overdose outcomes.
Wenger et al.: Best practices for community-based overdose education and naloxone distribution programs, Harm Reduction Journal, 2022 Expert consensus study that includes low-barrier, consistent, needs-based access as a best-practice theme.
Hanson et al.: Preventing opioid overdose with peer-administered naloxone in a rural state, Harm Reduction Journal, 2020 Study describing rural access barriers such as travel time, limited hours, and stock issues.
Freeman et al.: Barriers to naloxone access from pharmacies, BMC Public Health, 2022 Study of pharmacy-based naloxone access barriers, including privacy concerns, cost, misinformation, and stigma.
Tse et al.: Take-home naloxone and substance use outcomes, International Journal of Drug Policy, 2022 Systematic review examining whether take-home naloxone provision is associated with increased substance use or overdose.

Language and stigma

CDC: Stigma Reduction CDC guidance on how stigma affects people who use drugs and people seeking care.
NIDA: Words Matter - Terms to Use and Avoid When Talking About Addiction Guidance on person-centered language and terms to avoid when talking about substance use.
SAMHSA: Stigma and Language SAMHSA overview of stigma, language, and barriers to seeking help.