August 29, 2012
Naloxone is a safe, highly effective chemical compound that reverses the effects of opiates such as heroin. It has been used in clinical settings as an emergency treatment for opiate overdose for 40 years. In the USA and Europe, Take Home Naloxone programs have been linked with reductions in drug deaths of up to 34% (1). Naloxone has been approved for use in Canada for over 40 years and is on the World Health Organization List of Essential Medicines. Naloxone has no potential for abuse – in the absence of narcotics it exhibits essentially no pharmacologic activity. Naloxone will work only for drugs in the opiate/opioid family – it is not effective for overdoses of other drugs such as cocaine.
How can Naloxone help reduce the number of drugs deaths?
Naloxone can play a major role in preventing deaths – especially if it can be administered to someone in overdose as early as possible. To maximize the impact of Naloxone on drug deaths, it is necessary to have Naloxone available at the scene of the overdose before specialist help arrives. This means that Naloxone has to be available to members of the community for emergency use.
Access to Naloxone varies around the world, including take-home doses for people who use illicit drugs in Europe and Australia, and in Edmonton and Toronto. Scotland introduced a National Patient Group Directive in August 2010 to ease the development of take-home Naloxone programs. Patient Group Directives (PGD) allow Naloxone to be prescribed by appropriately qualified nurses and pharmacists. In Scotland, any person released from prison at risk of overdose is given training and a Naloxone kit (2). Naloxone is available over the counter in Turin, Italy. There are over 180 successful take-home Naloxone programs in the U.S., such as Project Lazarus in North Carolina, which has helped to distribute Naloxone to individuals who are at risk due to prescribed opiates (3).
In Canada, Naloxone is controlled as a Prescription Only Medicine (POM) under Schedule F of the Regulations for Canada’s Food and Drug Act. It is prescribed by doctors, on a named patient basis only, to those deemed to be at risk of opiate overdose. The availability of Naloxone is also affected by the provincial legislation governing pharmacies as well as professional bodies such as provincial colleges of physicians and surgeons. Scottish Drugs Forum. Take-home Naloxone: Reducing Drug Deaths. Available here.  National Services Scotland. 2012. National Naloxone Programme Scotland Monitoring Report – Naloxone Kits Issued in 2011/12. Available here.  Dasgupta, N. et al. 2008. “Project Lazarus: Overdose Prevention and Responsible Pain Management.” North Carolina Board of Medicine: Forum, p. 8. Available here.