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HOT TOPIC 2017 HTM file
Overdose deaths in the UK: crisis and response
One of our selection of hot topics – important issues which sometimes generate heated debate. Why did the fall in UK drug overdose deaths in 2009 to 2012 so decisively reverse in the following years? A life-threatening turn away from harm reduction, or simply an ageing population of heroin users?
HOT TOPIC 2017 HTM file
Overdose antidote naloxone takes harm-reduction centre stage
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. National programmes distributing the opiate overdose antidote naloxone have become the great hope for curbing the rise in overdose deaths, but England is lagging behind the rest of the UK – and planning for the likelihood not of recovery but relapse may for some services and patients be hard to accept.
In 2011 Scotland became the first country to fund a national policy of distributing the opiate-blocker naloxone to prevent deaths involving opiate-type drugs. According to this evaluation it did prevent deaths where the effect was most likely to be seen – in the weeks after release from prison.
STUDY 2016 HTM file
Reducing opioid-related deaths in the UK
The UK’s official drug policy advisers conclude that the ageing profile of heroin users with increasingly complex health needs has contributed to recent increases in drug-related deaths, and that to hold down the increases government must maintain investment in substitute prescribing programmes like methadone maintenance.
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.
REVIEW 2015 HTM file
Drug consumption rooms: an overview of provision and evidence
The European Union’s drug misuse monitoring centre says the evidence contradicts concerns that facilities where drug users can more safely use illegal drugs might counterproductively encourage drug use, delay treatment entry, or aggravate problems arising from local drug markets; instead both the users and the community benefit.
This real-world implementation of overdose education and nasal naloxone distribution in Massachusetts illustrates the life-saving potential of these programmes.
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.
Primary care methadone patients in Ireland were nearly four times more likely to die during periods out of treatment; the first few weeks after leaving were the peak risk period. The study’s support for unbroken, long-term treatment runs counter to recent UK government policy.
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