The opioid problem in the United States has worsened dramatically in the past 20 years, with opioid overdose deaths steadily increasing since 1999. More than 28,000 people died from opioid overdose in 2014, and more than 33,000 people died from opioid overdose in 2015. Unfortunately, the numbers continue to climb. Opioids include prescription painkillers like oxycodone, hydrocodone, and morphine as well as illicit drugs like heroin. Overdoses require immediate treatment, and by the time emergency responders arrive, it is often too late to save the person.
In March 2015, the U.S. Department of Health and Human Services launched the Opioid Initiative. The goals of this program are to improve the process of prescribing opioids, to make addiction treatment more accessible to those with opioid use disorders, and to increase naloxone use to stop or reverse overdoses.
Naloxone is a medication that reverses the effects of overdose when administered immediately. It is available as a prescription in every state in the U.S. and is available over-the-counter in many states. In recent years, naloxone has become much more widely available, and many organizations and local governments are pushing to make it even more accessible.
Naloxone is also known as an opioid receptor antagonist. It attaches to opioid receptors, which prevents other opioids in the body from taking effect. Overdose causes the depression of the central nervous system and respiratory system, which can stop the overdosing individual from breathing. Naloxone counteracts this, allowing the individual to breathe normally.
The drug is non-addictive and only has an effect if someone has opioids in their system. It does nothing to the body if there are no opioids present, so there is no risk of people abusing it. It can be injected into a muscle or vein or be administered as a nasal spray. Naloxone usually lasts between 30 and 90 minutes before wearing off.
There are two naloxone prescription products currently available. One is naloxone hydrochloride, a product for self-injection, and one is Narcan, a nasal spray. Nasal spray is especially beneficial when a bystander or layperson must administer the drug, because it requires less instruction than an injection.
Since 1996, more than 26,000 people have been saved from overdosing with the help of naloxone. As a part of the Department of Health and Human Service’s Opioid Initiative, the FDA is trying to make naloxone more accessible. Their main efforts currently involve trying to help manufacturers submit applications to the FDA to be allowed to sell over-the-counter versions of naloxone.
In addition to making naloxone available over-the-counter and in pharmacies, distributing naloxone kits and educating the community is also an important part of reducing opioid overdose deaths. For example, Massachusetts started a distribution program to give naloxone kits to opioid users as well as friends and families of opioid users. This gave people at risk of overdose much better access to naloxone, and it reduced opioid overdose deaths by 11 percent in 19 communities throughout the state.
Opioid overdose education and naloxone distribution, or OEND, programs teach people to recognize the signs of overdose and how to administer naloxone. Some programs use pamphlets and videos, while others prioritize hands-on training. The programs are sometimes led by community members and sometimes led by nurses, physicians, and pharmacists. There are OEND community programs in 30 states, and most programs have started in the last 20 years. With this training, opioid users, friends and family of opioid users, and other bystanders can administer naloxone and stop the overdose.
These community OEND programs are currently the most common method of naloxone distribution. Prescriptions dispensed at pharmacies have also risen in the past few years, especially in rural communities that don’t have OEND programs. Over-the-counter versions of naloxone are already available in many states and will hopefully became even more widely accessible in the next few years. Opioid use is a serious problem in the United States, but naloxone is reducing the number of deaths.
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