Every year, thousands of people around the world experience an overdose of opioids.
According to the World Health Organization, approximately 69,000 people around the world die of an opioid overdose annually, and in 2010, over 16,000 individuals died of an opioid overdose in the US alone. In response to this growing public health concern, many countries have initiated programs to train members of the public in the use of naloxone, an opiate antagonist that can reverse the initial effects of an overdose.
Opioids are a family of powerful natural or synthetic narcotics that are chemically based on morphine and other substances found in the opium poppy. This category includes street drugs like heroin, as well as pain relievers like morphine, codeine, oxycodone, hydromorphone, fentanyl and tramadol. The euphoric rush that opioids provide give them a high potential for abuse, addiction and overdose. Early intervention in an overdose using the drug naloxone might not necessarily be enough to save a person’s life, but it could slow down the process long enough to get further medical help.
Why Is Naloxone Important?
With the widespread recreational use of prescription opiates, the potential for opiate use and addiction is growing. Statistics from the Center for Behavioral Health Statistics and Quality indicate that with more Americans using opiate painkillers for non-medical reasons, the use of the opiate heroin is also on the rise:
- In 2011, 1.7 percent of Americans age 12 and over reported that they had used prescription opiates for non-medical reasons in the past 30 days.
- Between 2002 and 2011, 25 million Americans age 12 and older reported that they had abused opiate pain relievers at least once in their lifetime.
- Nearly 80 percent of heroin users report that they had abused prescription opiates in the past.
- Heroin abuse was 19 times more common among individuals who used opiate pain relievers for non-medical reasons than among those who did not.
Naloxone hydrochloride is an opiate antagonist drug that reverses the effects of heroin and other opiate drugs by binding to the receptor cells in the brain that respond to opioids. Once it is administered, naloxone acts for up to 90 minutes to counteract the effects of opiates. Sold under the trade name Narcan, it is frequently used in emergency rooms and other medical settings to prevent the central nervous system depression, respiratory suppression, and low blood pressure that can lead to death. Naloxone is also combined with opioid replacement drugs like buprenorphine (Suboxone) to keep the user from overdosing on the medication.
What Is a Take-Home Naloxone Program?
Most people who die of an opioid overdose are not alone at the time of death. According to the Ohio Department of Health
, approximately 87 percent of fatal overdoses occur in the presence of a family member, friend, or partner. In many cases, these individuals do not call 911 immediately because they are afraid of the legal consequences of drug use. Take-home naloxone programs give these individuals the means to start emergency treatment right away, while providing education about the importance of calling 911 and getting medical help as soon as possible.
Naloxone can be administered as a nasal spray or an intramuscular injection to people who have taken too much of an opioid street drug or pain reliever. In 1996, the first Naloxone Distribution Program, or NDP, was developed to train laypeople in the emergency use of naloxone and to distribute injectable doses of the drug to individuals certified in its use. The Harm Reduction Coalition
reports that there are currently about 200 communities in the US that have established take-home naloxone programs to reduce the risk of a fatal opioid overdose.
NDPs are administered by public health departments, clinics, and other agencies throughout the country to promote public safety and reduce the number of overdose-related deaths. In addition, these agencies provide education on opioid addiction and access to recovery services.
Who Qualifies for Naloxone Programs?
To qualify for a take-home naloxone program, participants must go through training in early response to an opioid overdose. Components of a standard NDP training program include:
- How to recognize the signs of an opioid overdose
- How to initiate rescue breathing to an unconscious victim
- How to contact emergency services to get medical treatment
- How to administer naloxone correctly
- How to prevent future overdoses
- Where to seek further treatment for opiate abuse
Naloxone is available to the public only with a prescription. Intravenous opioid users, as well as individuals on opioid replacement therapy with drugs like methadone or buprenorphine may be candidates for a take-home naloxone program.
The partners and family members of these individuals could also be trained in the emergency use of naloxone.
Are Naloxone Programs Successful?
Studies show that NDPs have been successful at reducing the number of overdose fatalities in communities that support these programs. In a survey of 50 NDPs across the US, the participating agencies reported that they had trained over 53,000 citizens in the use of naloxone and distributed the drug to them since 1996, according to the Morbidity and Mortality Weekly Report. The surveyed agencies stated that they had received reports of over 10,000 opioid overdose reversals during that time.
In addition to preventing overdose deaths, take-home naloxone programs may help reduce the risk of future overdoses by providing education and resources on opioid treatment. Many users who were not aware of their treatment options have been encouraged to seek help and get the support they need to recover from opioid addiction.
Why Is Naloxone Controversial?
Take-home naloxone programs have caused a certain amount of controversy. Some medical professionals, politicians and public organizations object to naloxone programs for the following reasons:
- Naloxone may not be administered safely by laypeople.
- Laypeople may not know how to respond to an adverse reaction to naloxone.
- Opiate users may not receive adequate follow-up care or seek out education about opioid addiction.
- Access to naloxone may make drug users more willing to take risks in their opiate use.
This opposition to naloxone programs has prevented some communities from prescribing and distributing the drug to the general public. Much of the opposition to NDPs is based on the assumption that opiate users will use naloxone as a safety net, allowing them to take larger doses of heroin or other opiates. However, according to the American Journal of Public Health, studies of opiate users consistently show that the use of naloxone to prevent an overdose did not encourage further opiate abuse. The journal goes on to state that pilot NDPs have proven safe and successful, and that the education they provide has inspired many users to get the help they need to lead drug-free lives.
Where Can I Get Help?
If you, or someone you know, are struggling with opiate addiction, help is available. The most effective way to prevent an opiate overdose is to seek treatment from a comprehensive recovery program. Opiate rehab programs can offer medically monitored detox, pharmaceutical therapy, individual psychotherapy, family and marriage counseling, and other treatment strategies that promote long-term recovery. For more information about opiate treatment programs that can help you, call us at the toll-free number above.