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As concern mounts about Britain's failure to reverse the recent growth in drug-related deaths, the first large-scale UK follow-up study has assessed the impact of training in overdose recognition and management featuring the opiate blocking drug naloxone.
Training for addiction treatment staff in managing overdose using naloxone, seeded in London by the National Addiction Centre, 'cascaded' to other staff and to patients at a disappointingly slow pace; on average each clinician trainee trained one drug user every 11 months.
STUDY 2011 HTM file
The NTA overdose and naloxone training programme for families and carers
Up to 18 lives were known (and more perhaps unrecorded) to have been saved after the National Treatment Agency in England piloted training for the carers of opiate users on how to administer the overdose-reversing drug naloxone. But how does catering for relapse in this way square with the optimism of the recovery movement?
REVIEW 2012 HTM file
Consideration of naloxone
The UK’s official drugs law and policy advisory body recommends that alongside training, the opiate-blocker naloxone be made more widely and easily available to enable drug users and those who work and associate with them to prevent opiate overdose deaths.
The evaluation which led to the Welsh national programme to distribute naloxone to opiate users and their associates to curb rising overdose deaths, one of several UK studies to give momentum to this peer-based strategy.
DOCUMENT 2014 HTM file
Community management of opioid overdose
Experts convened by the World Health Organization judged the risk-benefit profile to be strongly in favour of naloxone distribution to prevent opiate overdose deaths, but also cautioned that this “does not address the underlying causes of opioid overdose”.
REVIEW 2016 HTM file
Preventing opioid overdose deaths with take-home naloxone
To aid policymaking, experts commissioned by the European Union’s drug misuse monitoring centre review the evidence and offer guidance on the provision of the medication naloxone, which reverses the effects of drugs like heroin, helping to prevent overdoses becoming fatal.
This real-world implementation of overdose education and nasal naloxone distribution in Massachusetts illustrates the life-saving potential of these programmes.
Implication of this English study is that to save the lives of people dependent on heroin or similar drugs, they should be engaged and retained in substitute prescribing programmes like methadone maintenance until there is little risk of their relapsing after leaving. Shortly after leaving residential/inpatient settings was the highest risk period.
The first simulation of the cost-effectiveness of supplying naloxone kits to heroin users to enable them to prevent overdose deaths estimates that in the US context these programmes would be well within the range considered a cost-effective health intervention. Findings are likely to broadly apply to the UK, one weak link being whether drug users given the kits actually carry them around.
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