Lay summary
Fatal accidental opioid overdoses are increasing in New Zealand, up 32% in recent years. At the same time, there is growing availability of highly potent synthetic opioids in the community, including fentanyl and nitazenes, which can be lethal in tiny doses. In response, Medsafe removed prescription barriers and Pharmac-funded supply of naloxone, a life-saving overdose reversal medication, through selected health services in 2023. However, current health service delivery is not reaching its full potential, including for equitable access. This study will use mixed methods to assess naloxone service delivery outcomes, identify barriers and enablers, and co-design improvements to naloxone health service delivery, enhancing effectiveness and equitable access to a life-saving medicine. More effective health service delivery for naloxone will save lives, deliver significant health gains for individuals in the immediate and long term, reduce length of stay at emergency departments and is extremely cost-effective.