LEGISLATION
to allow
naloxone to be more widely
available for those who need
it is on track to be enacted
next month. This follows the
Advisory Council on the
Misuse of Drugs (ACMD)’s recommendation in 2013 and
a public consultation by the Medicines and Healthcare
products Regulatory Agency in 2014 that saw wide
support for the proposals.
The evidence shows that take-home naloxone given
to service users, and training family members or peers in
how to administer naloxone, can be effective in reversing
heroin overdoses. Because it is only available as an
injectable product, naloxone will remain a prescription-
only medicine but the legislation will permit people
working in commissioned, lawful drug treatment
services to supply naloxone without a prescription to
anyone needing it to prevent a heroin overdose.
Drug treatment services are generally seen to be
those providing specialist services, primary care drug
treatment, and needle and syringe programmes
(including pharmacy-based programmes).
These services will legally be able to order naloxone
and their staff will be able to supply it to individuals
without needing a prescription or any other written
instruction from a health professional. These individuals
could be drug users themselves, or it could be family
members, friends, carers or hostel managers who may
need easy access to the medication.
Services that work with drug users but do not provide
drug treatment would be unlikely to count as lawful
drug treatment services, so would not be able to supply
naloxone according to the new proposals. However,
these services could arrange for people to visit another
service that does supply naloxone or, using existing
mechanisms, could ask a doctor to prescribe naloxone if
the individual has been identified as at risk of overdose.
The legislation is about supply to individuals, so a
drug treatment service will not be able to supply stocks
of naloxone to another service.
Preliminary advice from the working group updating
the 2007 clinical guidelines on drug misuse and
dependence clarifies appropriate naloxone dosing in the
case of an overdose, naloxone products that can be
supplied, and training that should be provided.
Once legislated, commissioners will need to agree
how any new naloxone supply works locally, including:
• What naloxone product should be supplied and
how it should be packaged, if needed, to include
one or more needles and a sharps box.
• Which services will be funded to supply naloxone.
• Which groups of people should be able to receive
naloxone.
• How these groups might be prioritised and
whether there is any limit on how much naloxone
can be supplied.
• What record keeping is required to track supplies
and arrange for re-supply.
• What training should be provided alongside
naloxone.
PHE’s advice earlier this year –
–
covers many of these points and PHE is now considering
what further resources would be helpful to
commissioners before October’s legislative change.
Steve Taylor is programme manager,
alcohol, drugs and tobacco division, health
and wellbeing, Public Health England
Harm reduction
Much more on Naloxone at:
Naloxone is to be made more readily available next month.
Public Health England’s
Steve Taylor
looks at how local services
and commissioners can respond to this change in the law
10 |
drinkanddrugsnews
| September 2015
FACT FILE
What is naloxone?
Naloxone is an emergency antidote to opiate
overdose. It blocks opioid receptors to
counteract the effects of opioid drugs (such
as heroin, methadone and morphine),
reversing the life-threatening effects of an
overdose such as depressed breathing.
How do you administer it?
It is important first to call an ambulance,
check the person is breathing and put them
in the recovery position. Then simply attach
a needle (if not already fitted) to a pre-filled
syringe or minijet and inject the overdosed
person in a large muscle (thigh, buttock or
top of the arm).
Is it harmful?
Naloxone itself has no psychoactive
properties and ‘no intoxicating effects or
misuse potential’. It is injected directly into
the body so is quick to take effect.
Does it encourage risky behaviour?
Surveys of people who use opiates suggest
this is not the case. As naloxone works by
inducing rapid withdrawal from opioid drugs,
its use is likely to be something that people
who use these drugs are keen to avoid.
From PHE advice
Ready foR
action
