May 1, 2018 / 4:55 PM / 3 months ago

Take-home Narcan kits lifesaving in opioid overdoses

(Reuters Health) - Distributing take-home overdose prevention kits substantially reduced the number of deaths from opioid overdoses in a Canadian province, researchers say.

“The province of British Columbia in Canada has experienced a dramatic increase in the number of opioid overdose deaths in recent years, which led to a declaration of a public health emergency in April 2016,” coauthors Dr. Mark Gilbert and Mike Irvine told Reuters Health in an email.

In response, the province scaled up its Take-Home Naloxone program. Naloxone, also known as Narcan, quickly reverses the effect of opioid overdoses.

Gilbert and Irvine said they wanted to know “what sort of an impact the (the program) had, and how worse things might have been if there wasn’t any scale-up.”

As reported in The Lancet Public Health, Gilbert and Irvine and colleagues used multiple data sources to identify almost 23,000 ambulance-attended overdoses and just over 2121 illicit drug-related deaths from January 2012 through October 2016.

During that time, just over 19,000 take-home naloxone kits were distributed.

The researchers calculated that 298 deaths were prevented by the kits, including 226 in 2016 alone, following the rapid scale-up in distribution.

An earlier scale-up of the program would have averted an additional 118 deaths, the researchers say.

“Our study found that for every ten kits used, one death was averted,” Gilbert and Irvine said.

To date, more than 90,000 kits have been distributed in British Columbia, they noted.

“Unfortunately, many people believe that harm reduction and naloxone programs are not valuable, and we hope our study provides evidence that can be used to advocate for wide-scale naloxone distribution programs,” they said.

Gilbert is medical director of the British Columbia Centre for Disease Control, and Irvine is a researcher at the University of British Columbia.

Catherine Comiskey of the University of Dublin in Ireland, who wrote an editorial published with the study, said there’s no magic solution to the problem of opioid addiction and overdoses.

The kits are “absolutely” a necessary component, “but there needs to be more,” Comiskey told Reuters Health.

“(In Ireland), we have a health-led response in our national drug strategy because we believe that . . . a basic human right is to have a health-led response,” Comiskey said.

Police, education, social services, and the health services are all committed to a health-led response, said Comiskey.

“So, for example, we’ve just changed our legislation now so that we can introduce safe-injecting centers,” she said.

Opioids include the prescription pain relievers oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and others. But the increase in deaths in British Columbia was primarily driven by overdoses of the painkiller fentanyl, an opioid a hundred times more powerful than heroin.

In the U.S., Narcan can be purchased from pharmacies over-the-counter in 49 states. In Nebraska, it’s available with a physician’s prescription.

SOURCE: bit.ly/2vOm89Q and bit.ly/2vOGfVh The Lancet Public Health, online April 17, 2018.

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