Keep Calm and Carry Naloxone

Recent media reports highlight new research calling for increased access to naloxone as a safe, effective and evidence-based public health strategy.  Distribution of naloxone, often referred to by the brand name Narcan, has been described as a cost-effective method to “cut the death rates from overdose nearly in half” while reducing long-term public health spending on overdose related interventions^1,2.

What is Naloxone?Naloxone is a non-toxic, non-addictive medication that works as an antidote to opioid overdose. Opioids include commonly used drugs such as heroin, oxycontin, and morphine.  Naloxone works to “reverse” an opioid overdose by counter-acting the often fatal depression of respiratory and central nervous systems. If there are no opioids in a person’s system, naloxone has no effect.  Naloxone is administered through injection or nasal spray.

Is Naloxone a new development?Naloxone has been used in clinical settings across Europe, Australia, Canada and the United States for over 40 years.  The World Health Organization has included naloxone on its List of Essential Medicines³ .

Who has access to Naloxone?In some countries, naloxone is available over the counter, but in Canada it is controlled under the Food and Drug Act as a prescription-only medicine.  Naloxone has been available through Edmonton’s Streetworks Program and at Insite in Vancouver.  Take-home and peer-based naloxone access programs are gaining support in a number of areas across the world.

Why is Naloxone access important? According to a 2012 article in the British Columbia Medical Journal, “the current lack of naloxone availability outside primary care, hospital, and ambulance settings limits its lifesaving potential”. The article “seeks to increase physician awareness about the safety, effectiveness, and evidence that increasing access to naloxone saves lives” and describes how access initiatives “can provide an opportunity to engage in meaningful dialogue and empower people who use opioids to take responsibility for themselves and others” ⁴. 

Sources

1. Szalavitz, M. Wider use of antidote could lower overdose deaths by nearly 50%. Retrieved from http://healthland.time.com/2013/02/05/wider-use-of-antidote-could-lower-overdose-deaths-from-by-nearly-50/#ixzz2LZAjnyda

2. Coffin, P., Sullivan, S. (2013). Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. Annals of Internal Medicine.  158(1).  Retrieved from http://annals.org/article.aspx?articleid=1487798

3. World Health Organization. Model lists of essential medicines. Retrieved from http://www.who.int/medicines/publications/essentialmedicines/en/index.html

4. Buxton, J. et al. (2012). Increasing access to naloxone in BC to reduce opioid overdose deaths.  BCMJ. 54(5).  Retrieved from http://www.bcmj.org/bc-centre-disease-control/increasing-access-naloxone-bc-reduce-opioid-overdose-deaths