Take Home Naloxone to Prevent Deaths from Opiate Overdose
EDITOR-Dettmer et al reported on the distribution of naloxone to
drug users for use in overdose emergencies . The state of New Mexico led
the United States in heroin-related induced deaths in 1996-1999. The per
capita death rate was 11.7 per 100,000 inhabitants compared to the per
capita heroin-related death rate of 5.3 deaths per 100,000 nationally
according to the Bureau of Vital Records and Health Statistics, Public
Health Division, New Mexico Department of Health, from 1993-1995. Rio
Arriba County in New Mexico has one of the highest heroin related
mortality rates in the country of 18 per 100,000.
Due to concerns over possible arrest and incarceration, observers of
heroin overdoses, who are often also heroin users, are reluctant to call
for an ambulance in overdose emergencies. In one study, an ambulance was
called for in only half of the overdose situations. A more effective
response by witnesses to life threatening overdoses would probably save
lives. Some authorities have advocated training in the use of the narcotic
antagonist naloxone and the distribution of naloxone to heroin users in
order to save lives in heroin-related overdose emergencies.3,4,5
In January of 2001, the New Mexico Department of Health began issuing
100 pre-filled syringes of naloxone to physicians in Rio Arriba County in
northern New Mexico for prescribing to heroin using patients. Since then,
in at least two cases, a family member or other witness has used naloxone
from this program to treat a heroin overdose. In both cases, the patients
required rescue breathing and were resuscitated by the naloxone. On March
27, 2001 New Mexico Governor Gary Johnson signed into law an act authoring
and releasing from liability non-medical personnel who administer opioid
antagonist in drug overdoses while acting in good faith.
We commend Dettmer et. al. for their preliminary work on take home
naloxone and believe that a study is needed of wider distribution of
naloxone to prevent needless deaths from opioid overdose.
Catherine T. Baca, MD
Center on Alcohol, Substance Abuse, and Addictions,
University of New Mexico Health Sciences Center
Rapid Response:
Take Home Naloxone to Prevent Deaths from Opiate Overdose
EDITOR-Dettmer et al reported on the distribution of naloxone to
drug users for use in overdose emergencies . The state of New Mexico led
the United States in heroin-related induced deaths in 1996-1999. The per
capita death rate was 11.7 per 100,000 inhabitants compared to the per
capita heroin-related death rate of 5.3 deaths per 100,000 nationally
according to the Bureau of Vital Records and Health Statistics, Public
Health Division, New Mexico Department of Health, from 1993-1995. Rio
Arriba County in New Mexico has one of the highest heroin related
mortality rates in the country of 18 per 100,000.
Due to concerns over possible arrest and incarceration, observers of
heroin overdoses, who are often also heroin users, are reluctant to call
for an ambulance in overdose emergencies. In one study, an ambulance was
called for in only half of the overdose situations. A more effective
response by witnesses to life threatening overdoses would probably save
lives. Some authorities have advocated training in the use of the narcotic
antagonist naloxone and the distribution of naloxone to heroin users in
order to save lives in heroin-related overdose emergencies.3,4,5
In January of 2001, the New Mexico Department of Health began issuing
100 pre-filled syringes of naloxone to physicians in Rio Arriba County in
northern New Mexico for prescribing to heroin using patients. Since then,
in at least two cases, a family member or other witness has used naloxone
from this program to treat a heroin overdose. In both cases, the patients
required rescue breathing and were resuscitated by the naloxone. On March
27, 2001 New Mexico Governor Gary Johnson signed into law an act authoring
and releasing from liability non-medical personnel who administer opioid
antagonist in drug overdoses while acting in good faith.
We commend Dettmer et. al. for their preliminary work on take home
naloxone and believe that a study is needed of wider distribution of
naloxone to prevent needless deaths from opioid overdose.
Catherine T. Baca, MD
Center on Alcohol, Substance Abuse, and Addictions,
University of New Mexico Health Sciences Center
Michael Richards, MD, MPA
State EMS Medical Director
New Mexico Department of Health
Kenneth J. Grant, MD
Family and Community Medicine
University of New Mexico Health Sciences Center
References
1. Dettmer K, Saunders B, Strang J, BMJ
2001;322:895-896 ( 14 April )
2. Darke S, Ross J, Hall W. Overdose among heroin
users in Sydney, Australia: II.
Responses to overdose. Addiction 1996;
91(3):413-417
3. Abbasi K, Deaths from heroin overdose are
preventable. BMJ1998; 316(7128): 331
4. Darke S, Hall W. The distribution of naloxone to
heroin users. Addiction 1997;
92:1195-1199
5. Strang J, Darke S, Hall W, Farrell M, Ali R.
Heroin overdose; the case for take-home
naloxone. British Medical Journal 1996; 312:1435
Competing interests: No competing interests