Naloxone Distribution Programs for Opioid Overdose Prevention: Time to Scale Up?

The rate of overdose deaths continues to rise in the United States. Prevention programs that distribute naloxone to lay persons and train them in its use have been disseminated as a strategy to reduce overdose mortality. In this national survey, investigators queried 50 opioid overdose prevention programs regarding the number of persons trained to administer naloxone and the number of overdose reversals. Forty-eight programs provided data from 1996 (when naloxone distribution began) to 2010.

• The 48 programs that responded provided data for 188 local overdose prevention programs.
• More than 53,000 people were trained and received naloxone for potential distribution.
• More than 10,000 overdose reversals were reported to the responding programs.
• Three-quarters of states with overdose death rates above the median did not have opioid overdose prevention programs.

Comments:

Based on this survey, opioid overdose prevention programs are feasible and provide the means to reverse overdoses, but they are not widely distributed. It cannot be determined from the data whether all reversals were life-saving or whether they were appropriately provided. Furthermore, this report did not provide surveillance on risks of treatment. However, the benefits are potentially significant and may provide a means to reduce overdose deaths. As one editorialist noted, harm-reduction and syringe-exchange programs have adopted naloxone distribution. As deaths from prescription opioids rise, health centers, physician offices, and pain clinics might be additional sites for naloxone distribution in order to reach a wider population at risk for overdose.

Hillary Kunins, MD, MPH, MS

Reference:

Wheeler E, Davidson PJ, Jones TS, et al. (CDC): Community-based opioid overdose prevention programs providing naloxone—United States, 2010. MMWR Morb Mortal Wkly Rep. 2012;61(6):101–105.