Prescription Naloxone: A Novel Approach to Heroin Overdose Prevention

The mortality and morbidity from heroin overdose have increased in the United States and internationally in the last decade. The lipid solubility allows the rapid deposition of heroin and its metabolites into the central nervous system and accounts for the “rush” experienced by users and for the tox...

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Bibliographic Details
Published in:Annals of emergency medicine 2007-02, Vol.49 (2), p.172-177
Main Authors: Sporer, Karl A., MD, Kral, Alex H., PhD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Drug intoxications. Doping
Drug Prescriptions
Emergency
Female
Heroin Dependence - mortality
Heroin Dependence - prevention & control
Humans
Intensive care medicine
Legislation, Drug
Male
Medical sciences
Naloxone - adverse effects
Naloxone - therapeutic use
Narcotic Antagonists - adverse effects
Narcotic Antagonists - therapeutic use
Pharmacology. Drug treatments
United States
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Summary:The mortality and morbidity from heroin overdose have increased in the United States and internationally in the last decade. The lipid solubility allows the rapid deposition of heroin and its metabolites into the central nervous system and accounts for the “rush” experienced by users and for the toxicity. Risk factors for fatal and nonfatal heroin overdoses such as recent abstinence, decreased opiate tolerance, and polydrug use have been identified. Opiate substitution treatment such as methadone or buprenorphine is the only proven method of heroin overdose prevention. Death from a heroin overdose most commonly occurs 1 to 3 hours after injection at home in the company of other people. Numerous communities have taken advantage of this opportunity for treatment by implementing overdose prevention education to active heroin users, as well as prescribing naloxone for home use. Naloxone is a specific opiate antagonist without agonist properties or potential for abuse. It is inexpensive and nonscheduled and readily reverses the respiratory depression and sedation caused by heroin, as well as causing transient withdrawal symptoms. Program implementation considerations, legal ramifications, and research needs for prescription naloxone are discussed.
ISSN:0196-0644
1097-6760
DOI:10.1016/j.annemergmed.2006.05.025