The naloxone consultation: landmark opportunity to expand the provision of naloxone

Photo by lilartsy on Unsplash

Katherine Watkinson, Acting Head of Medicines Optimisation and Pharmacy at Turning Point, discusses how a new government consultation could make naloxone more accessible. 

Drug-related deaths have more than doubled since 2012 and recent figures show no sign of this trend slowing down[1]. England and Wales registered 4,561 drug related deaths during 2020 which is the highest on record and a 3.8% increase on the previous year[2]. Since 2012, drug related deaths have risen from 46.6 people per million to 79.5 per million in 2020[3]. Heroin overdose is the leading cause among deaths from drug poisoning[4].

In response to this growing public health crisis, the government have launched an open consultation, testing the waters on potential amendments to the Human Medicines Regulations (2012). These amendments would broaden the types of services which could stock and provide naloxone to individuals without a prescription. We believe this is a positive step towards ensuring naloxone becomes as accessible as possible to those who need it.

So, what is naloxone? Naloxone is a medication used to block the effects of opioids. The medication is effective for the reversal of a heroin overdose in emergency situations and can be used by non-medical responders such as police officers, hostel workers, and friends and family. Naloxone can be administered in two forms: nasally or as an injection.

The effectiveness of naloxone is, in part, attributed to the fact it is universally safe to use. Like all medicines, naloxone can produce common side effects, however these side effects occur infrequently and most importantly, there are no pre-existing conditions which can cause complications when an individual is administered naloxone.

At Turning Point, we believe naloxone should be supplied to as many individuals and stocked in as many locations as possible, not just people who are in structured treatment. It has been repeatedly demonstrated that wherever naloxone has been more accessible it has had a positive effect on reducing drug-related deaths. A systematic review published in 2018 found that:

“On the basis of the most current evidence, there is overwhelming support of take-home naloxone programs associated with decreased mortality among those who abuse opioids. As a result, there is an implication for a practice change that take-home naloxone programs should be more widely implemented throughout communities as a method of decreasing mortality associated with opioid overdoses.”[5]

Here at Turning Point we not only offer, but strongly encourage all opiate users who use our services to accept and carry naloxone and try to work through any reasons given for refusal. Since the pandemic, we have posted naloxone out to clients as well as leaving it with local pharmacies to ensure it continues to remain accessible.

Our belief in expanding and widening the use of naloxone as much as possible is also reflected in our work with various agencies including homelessness services, the HM Prison and Probation service, pharmacies, and our own substance misuse services. In our work alongside these agencies, we only ever find willingness and demand for naloxone, and we believe that these services are very likely to stock naloxone if it were available.

Currently, hostel staff and others that indirectly work with opioids users are unable to supply naloxone directly, which makes it difficult to provide for people that are not engaged in drug treatment services and who are among the groups at greater risk of overdose.

Read the full blog post here.

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