New research from the Monash Addiction Research Center and the Burnet Institute shows that making the opioid overdose antidote, naloxone, easily accessible and freely available to people who are prescribed opioids in Australia would be cost effective and save hundreds of lives .
The study authors also identify the need to raise awareness and provide targeted information to general practitioners and pharmacists who prescribe and dispense naloxone, as well as to those who use it.
Naloxone is a safe and effective drug that reverses the effects of opioid drugs such as heroin, morphine, and oxycodone if given by injection or by nasal spray to someone who has overdosed.
While most research has focused on people who inject heroin, most opioid-related deaths in Australia involve prescription opioids, which are used by three million Australians, including 300,000 in Australia. who are prescribed long-term opioids.
In Australia, “take-home naloxone” (THN), which typically includes training and education on opioid prevention and naloxone use, is available in all states and territories by prescription or over the counter in a pharmacy for a fee – or free without a prescription from licensed providers in New South Wales, Western Australia and South Australia as part of a Commonwealth pilot program.
Published in the journal Addiction, the collaborative study led by Suzanne Nielsen, Associate Professor at the Monash Addiction Research Center and Paul Dietze at the Burnet Institute, is the first to model the cost and impact of distributing THN to people who use opioids outside of the home. injection drug use.
It shows that increasing THN by 2030 to reach 90% of people prescribed at medium and high doses of opioids would save more than 650 lives – with 146 additional deaths averted each year from 2030 – and would be profitable ($ 43,000 per life saved).
“One of the questions we were asking ourselves was, given the large number of people who receive prescription opioids in Australia, does it make sense to offer naloxone widely given that there is a cost for each dose? provided, ”Associate Professor Nielsen said.
“This paper demonstrates that it pays to provide naloxone for free to people because the price of naloxone is low, but the payoffs are high.”
Based on current trends, there will be 7,478 prescription opioid overdose deaths in Australia between 2020 and 2030, alone resulting in $ 51.9 million in ambulance costs.
Prof Paul Dietze said the results of the Commonwealth Pilot Program, which is currently under evaluation, could provide a framework for maximizing the impact of THN nationally.
“Assuming the pilot project to liberalize access to naloxone yields positive results, these must be properly implemented across the country,” said Professor Dietze.
“We need to know how many people we need to reach to maximize the impact, identify how many doses need to come out and where the gaps are.”
“We really have to deploy this kind of initiative quickly because people are dying right now. “
Importantly, the study authors highlight the need to overcome frontline barriers to the supply of THN, including the stigma among pharmacists who may associate naloxone with the use of illicit substances, as well as the low levels of drug use. trust and understanding.
The authors recommend targeted education for pharmacists, prescribers, and the general population to make the role of naloxone clear to those who provide and receive it.
“The implementation in pharmacies should be very simple,” Associate Professor Nielsen said. “You don’t need complicated rules to know who gets it. Offering naloxone to everyone who takes strong opioids makes sense. “
“But just having the drug available may not be enough – we need to educate and educate people who take prescription opioids why they could be offered naloxone and increased use in this way. “
“Prescribers and pharmacists must be properly equipped to have the conversation with people so that they understand that opioids are high risk drugs, and this requires the contribution of cutting edge organs and the support of government and others. agencies. “
The Federal Department of Health funded this collaborative study between the Burnet Institute, the Monash Addiction Research Center and the National Drug Research Institute at Curtin University.