Drug Legalization

Wider Availability of Life-Saving Naloxone Saves Lives; Still Not Over-the-Counter Legal


Time's indispensable drug beat writer Maia Szalavitz with the lastest on the should-be-over-the-counter anti-opiate overdose drug naloxone:

Distributing naloxone and training people to use it can cut the death rates from overdose nearly in half, according to a new study.

Around 15,000 people die each year by overdosing on opioid pain relievers such as Oxycontin, a rate that has more than tripled since 1990. The government has tried numerous strategies to reduce the death toll, including imposing stricter regulations on prescribing the medications, prosecuting owners of "pill mills" who dispense the drugs without proper medical evaluations, and tracking databases to monitor prescribing and discourage "doctor shopping" among addicts.

But those policies have not had a significant effect on death rates from overdoses, according to the study's lead author Dr. Alex Walley, the medical director of the Massachusetts Opioid Overdose Prevention Pilot at the state's department of public health. So he and his colleagues wanted to study the impact that an antidote, the nontoxic and non-addictive medication known as naloxone (Narcan), might have on these rates…..

The new study, published in the BMJ, followed the expansion of Overdose Education and Naloxone Distribution (OEND) programs in Massachusetts, a state where overdoses from opioids have killed more people than car crashes each year since 2005.  The programs were offered at emergency rooms, primary care centers, rehabilitation centers, support groups for families of addicted people and other places that might attract those at risk….

The study involved 2912 people in 19 different Massachusetts communities —  each of which had had at least 5 opioid overdose deaths between 2004 and 2006.  The participants were trained to recognize overdose, call 911 and administer naloxone using a nasal inhaler.  If the naloxone didn't work, they were instructed to try another dose and perform rescue breathing until help arrived. The state's OEND programs began in 2006 and were expanded throughout the study period, which followed the trained participants until 2009.

During that time, 153 naloxone-based rescues were reported, and in 98% of those cases, the drug revived the victim. Even more importantly, the study found that the high levels of participation in an OEND program was associated with lower death rates from overdose.  Communities in which 1 to 100 people were enrolled in the program per 100,000 in the population had an overdose death rate that was 27% lower than those without such programs.

But communities with 100 or more people per 100,000 who had been through an OEND program saw death rates fall by 46% compared to those with no programs.  The study controlled for population factors such as poverty and the presence of high numbers of "doctor shoppers" that could have skewed the overdose death rates when calculating the results.

There is no question this drug should be over the counter legal in this country; the ball is in the FDA's court.

Past Reason articles on naloxone.


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  1. There is no question this drug should be over the counter legal

    Therefore, it must remain UNlegel, lest legions of Americans become addicted to NOT overdosing and therefore do MORE UNlegel teh drugz and create a WORSE epidemic of prescription drug abuse!

    God DAMN, Reason! Why do you hate the addicts?

  2. Around 15,000 people die each year by overdosing on opioid pain relievers such as Oxycontin, a rate that has more than tripled since 1990. The government has tried numerous strategies to reduce the death toll

    WTF? Why?

    1. Indeed, they are merely an expensive burden, removing itself.

      /Death Panel

    2. I wondered that too. And weren’t pain pills easier to get back in the 1990s?

      What I would also like to know is how many of those were accidental overdoses versus suicides. I don’t think suicides should count on OD statistics anymore than they should count on “gun death” statistics. The implication of saying someone died of an overdose is that they didn’t mean to kill themselves.

    3. 15,000 is really small in a country of 300 million. People throw out these numbers like they mean something in isolation. No matter what some number of people are going to die of overdoses of opioids.

      1. Yeah. And the other thing they don’t mention is that motor vehicle deaths have dropped by nearly a third since 1990. In 1990 over 45,000 people died in motor vehicle accidents.


        In 2011 it was down to 32,000.


        So the whole “it now exceeds traffic deaths” sounds really scary as long as you take it totally out of context.

      2. Yeah, this is what I’m thinking. Do we really need to spend millions of dollars to try to stop 0.005% of the population from dying?

        1. It is not even .005%. Remember that figure includes people who intentionally overdose and would probably have found another way to kill themselves if the pills were not available.

  3. Wider Availability of Life-Saving Naloxone Saves Lives; Still Not Over-the-Counter Legal

    Feature, not bug /drug warrior

  4. If you give little girls the HPV vaccine it’ll make’em have TEH SEX!

    1. Tweet of the year so far

      My assault rifle has killed fewer children than your girlfriend’s anti-vaccination advocacy.

  5. We wouldn’t want to send the wrong message.

  6. If people stop dying of overdoses, how the hell are we going to justify DEA crack downs? You people ever hear of unintended consequences?

  7. Narcan sounds a lot less interesting than a big needle of adrenaline injected into the heart. At least that’s what I learned from Pulp Fiction.

  8. absolutely 100% agree.

    i’ve seen people die from heroin overdose and i’ve been involved in “saves” of same. it’s tragic and narcan is such a miraculous life-saver (and man, does a heroin addict get upset when administered narcan – instand withdrawal symptoms)

    from a harm reduction stance, every state should have over the counter syringes (mine does). but they should also have OTC narcan. stats show most overdoses are witnessed, thus the utility of narcan.

    also, states should have (mine does) good samaritan laws, so co-users aren’t afraid to call 911 out of fear of arrest.

    these are common sense, lifesaving, compassionate measures that can be taken to save lives.
    and they should be

  9. Yes, Narcan should absolutely be available OTC. I have no idea how well a nasal spary works (I’ve never even heard of it until this article), but I’ve been saying for some time that it should be available in autoinjectors. The only problem would be convincing narcotic users that they should use it when they are overdosing, because when you give them Narcan in the ER, they get pissed. I’ve even had them tell me that I owe them $50 for the Roxys I just wasted.

  10. Dude is like totally rocking it man. WOw.


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