During the 17.5-year period, half of all naloxone doses dispensed by Prevention Point Pittsburgh were:
- 1 mL (0.4 mg/mL) vials (n = 35,715; 50.8%)
- 10 mL (0.4 mg/mL) vials (n = 18,420; 26.2%)
- 4 mg nasal spray (n = 16,063; 22.9%)
- Only 36 doses of the autoinjector were dispensed during a one-month period in 2016 with donated product
During the first decade of operation (Fig 5), Prevention Point Pittsburgh distributed the 10 mL vial exclusively.
Yellow sparkline below the main time trends panel are provided to visualize fluctuations in monthly counts of naloxone doses distributed.
Programmatic context
Program staff provided context for the two points where lines crossed. Initially the 10 mL vial was the only formulation available, but the 10 mL vial was replaced by 1 mL vials starting in October 2012 due to a new contract with the manufacturer. With this transition, by August 2013 all IM distribution was of 1 mL vials, packaged by the program as kits containing two 1 mL vials. The other line crossing occurred in Spring 2021 when a manufacturing problem disrupted 1 mL vial production. From May 2021 to September 2022, a manufacturing shortage of affordable naloxone led to a shortage of the 1 mL vials. The State of Pennsylvania was able to increase bulk nasal naloxone to Prevention Point, but the organization had to hire a part-time staff person to help other community-based programs with accessing the state ordering portal. After the shortage was resolved, 1 mL vial purchases resumed in late 2022.