Stopping an overdose: the story of take-home naloxone

Dependence on opioid drugs, such as heroin and many commonly used prescription painkillers, is a major international healthcare concern, with an estimated 69,000 people dying each year from opioid overdose.¹

This problem extends to Europe, where there are approximately 1.3 million opioid users at risk of overdosing, and where opioids account for the majority of the 6,000–8,000 registered overdose fatalities that occur each year.^2,3 In addition, recently published data on drug-related deaths in England, Wales and Scotland have shown, rather worryingly, that opioid-related deaths are on the rise.^4,5

Several strategies have been developed in response to the concerning high rates of opioid-related deaths; a subset of these are used to prevent overdoses from occurring, while others aim to reverse the effects of an overdose when they do occur.³ One such intervention of stopping an overdose when it does occur involves distributing naloxone, an opioid receptor antagonist, to opioid users and people likely to witness an overdose. When administered on time, naloxone is able to completely reverse an opioid overdose and thus stop a person from dying.^1,3

The life-saving potential of naloxone is the reason why, for decades, advocates have been campaigning for the implementation of take-home naloxone (THN) programmes in medical and nonmedical settings.^6,7 These schemes are incredibly important as they provide overdose education and training, and distribute naloxone kits to people at risk of overdose and those who are likely to witness one (e.g. users’ peers and hostel staff).^6,7 Furthermore, the link between THN programmes and reduced opioid-related mortality rates is strongly supported by many pieces of compelling evidence that have been published in recent years.^8,9,10

With this in mind, it is a pity that in Europe no more than 10 countries have introduced THN programmes.³ Indeed, significant barriers (legal, clinical and patient-level) preventing access to naloxone still exist in several European countries.⁶

However, the situation is changing: the number of European countries introducing THN programmes is on the rise, as is support for naloxone distribution from clinical guidelines, governments and international strategy plans.^3,11 In exciting news, the UNODC-WHO-led S-O-S Initiative was launched this year and details a much-needed strategy for reducing rates of opioid overdose deaths at a global level by increasing naloxone availability and training to all individuals likely to witness an overdose.¹²

This is one of the many much-needed steps in the right direction, but more should be done to counteract the worrying high rates of opioid overdose mortality, which in Europe are on the rise.¹³ Therefore, it is imperative for clinicians, policy-makers and governmental bodies to actively work together to provide wider access to naloxone and to overcome any remaining barriers that prevent THN programmes from being implemented. Accomplishing this will be key to saving and improving the lives of many, both across Europe and the world.