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.