Intended for healthcare professionals


Emergency naloxone for heroin overdose

BMJ 2006; 333 doi: (Published 21 September 2006) Cite this as: BMJ 2006;333:614
  1. John Strang (, director,
  2. Michael Kelleher, consultant psychiatrist in the addictions,
  3. David Best, honorary senior lecturer in the addictions,
  4. Soraya Mayet, specialist registrar in the addictions,
  5. Victoria Manning, research worker in the addictions
  1. National Addiction Centre (Institute of Psychiatry/The Maudsley), London SE5 8AF
  2. National Addiction Centre (Institute of Psychiatry/The Maudsley), London SE5 8AF

    Should it be available over the counter?

    Naloxone saves lives. Timely injection of the opiate antagonist naloxone rapidly reverses the respiratory suppression of heroin overdose,12 a major cause of death in young people.34 Recent regulatory amendments increase significantly the extent to which naloxone can now be used to prevent opiate overdose deaths. In June 2005, in the Medicines for Human Use (Prescribing) (Miscellaneous Amendments) Order,5 the United Kingdom added naloxone to the limited list of medicines that may be given by injection “by anyone for the purpose of saving life in an emergency” (alongside emergency adrenaline, glucagons, and snake antivenin). An emergency dose of naloxone may now be given to prevent death from heroin overdose without specific medical instruction. In August 2005, New York state passed legislation (bills A.7162-A (Dinowitz) and S.4869-A (Hannon)) establishing that physicians may lawfully prescribe naloxone explicitly for potential future opiate overdose, including the situation where it may …

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