Targeted Naloxone Distribution
Naloxone is an opioid antagonist that can quickly and safely reverse the potentially fatal effects of an opioid overdose. Targeted distribution programs seek to train and equip individuals who are most likely to encounter or witness an overdose—especially people who use drugs and first responders— with naloxone kits, which they can use in an emergency to save a life. There are many different approaches to distributing naloxone to people at high risk of experiencing or witnessing an overdose. Effective approaches include community distribution programs, co-prescription of naloxone, and equipping first responders
| Why this strategy works |
Targeted naloxone distribution works best when: |
Naloxone is a drug that carries no risk of abuse
and has no effect on individuals who do not already have opioids in their system. It does not generate physical dependency. It produces no neurological or psychological effects or euphoria. It also poses negligible risk of harm if misused. The people who most often witness and respond to an overdose are other persons who use drugs. By equipping these individuals with naloxone and training them to identify and respond to an overdose, the potential delay between the onset of an opioid overdose and the delivery of life-saving care can be reduced from hours to seconds. This is especially true in rural areas, where residents may experience longer EMS response times.9 With powerful opioids, like fentanyl and fentanyl analogs, appearing in the U.S. drug supply, higher doses of naloxone may be needed. Therefore, ready access to naloxone among members of the lay community and first responders is key for saving lives. |
- Naloxone is provided to people at high risk of experiencing or witnessing overdose.
- Outreach workers, harm reduction staff, and trusted clinicians, are properly educated and comfortable distributing naloxone to those using illicit opioids or receiving a high-risk opioid prescription.
- People wo use drugs and first responders are well informed as to the potential effects and actions of naloxone is crucial.
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Targeted naloxone distribution-What the research says
- A nation-wide study found that more than 80% of overdose reversals with naloxone in the U.S. were carried out by individuals who also use drugs. A similar study carried out in Massachusetts found that nearly 90% of overdose reversals with naloxone were carried out by the bystanders who also use drugs.
- An observational study of a naloxone distribution program in British Columbia recorded the distribution of 836 naloxone kits to people who use drugs and 85 reported overdose reversal from among those trained and equipped with naloxone by the program, indicating that at least one in every ten kits distributed had saved a life.
- An observational study in Ohio found that increases in the number of law enforcement officers trained and carrying naloxone was associated with a reduction in opioid overdose deaths and an increase rate of survival among opioid overdose victims in the surrounding area.
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- A retrospective review of all program enrollee information collected by the Massachusetts Department of Public Health Overdose Education and Naloxone Distribution Program found that family members of persons at risk of overdose comprised nearly 30% of the program’s enrollees and were responsible for 20% of all recorded rescue attempts. Some of those rescues were performed on someone other than the relative these participants were originally concerned about. These findings indicate that naloxone distribution across families and social networks can have lifesaving, synergistic effects.
- An observational study of nearly two thousand individuals who had received an opioid prescription over a two-year period found that those individuals who were co-prescribed naloxone along with their opioid analgesic prescription had 47% fewer visits to the emergency department in the 6 months after receiving the prescription and 63% fewer emergency department visits after 1 year.
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