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It pays to distribute naloxone to heroin users

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f76 (Published 09 January 2013) Cite this as: BMJ 2013;346:f76

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Distribution of the opioid antagonist naloxone to heroin users for use at witnessed overdoses probably reduces deaths and seems highly cost effective, say researchers. The modelling study examined hypothetical scenarios set in the US and compared distributing naloxone to 20% of heroin users with no intervention.

In the base case scenario, distribution of naloxone prevented 6% of deaths by overdose, one for every 227 kits distributed (95% CI 71 to 716). The distribution of naloxone increased lifetime costs by $53 (£33; €40; 95% CI $3 to $156) and quality adjusted life years by 0.119 (0.017 to 0.378), giving an estimated incremental cost effectiveness ratio of $438 ($48 to $1706). In sensitivity analyses, distribution was cost saving in some scenarios and cost effective in all. In the worst case scenario—where overdoses were rarely witnessed and naloxone rarely used, minimally effective, and expensive—the incremental cost effectiveness ratio reached $14 000.

Notes

Cite this as: BMJ 2013;346:f76