Emergency naloxone for heroin overdose: Over the counter availability needs careful consideration

doi:10.1136/bmj.333.7571.754

BMJ 2006;333:754 (7 October), doi:10.1136/bmj.333.7571.754

Letter

Emergency naloxone for heroin overdose

Over the counter availability needs careful consideration

The first 150 words of the full text of this article appear below.

EDITOR—In their support for making naloxone freely available,Strang et al state that naloxone saves lives,¹ yet it can alsobe dangerous, even lethal.² Many other reports of adverse reactionsare from use in health care, so more harm is likely in the handsof untrained people, especially as some may be intoxicated themselveswhen the drug is used. This needs to be carefully balanced bythe likely benefits and other viable alternatives to addressmortality from overdose, given finite budgets and workforce.

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Why Strang et al dwell on the wording of existing local prohibitionsis unclear. As with injecting centres, a community naloxonetrial would require indemnifying legislation. A localised pilotstudy in a high risk town might use other towns as controls.

Apart from theoretical endorsement on pharmacological grounds,the only reference Strang et al give supporting community naloxoneis an unpublished communication (D Bigg, Chicago). . . . [Full text of this article]

Andrew Byrne, dependency physician

75 Redfern Street, Redfern, NSW 2016, Australia ajbyrne@ozemail.com.au

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