People dying from heroin overdoses are usually young. Those who are fortunate enough to survive can face lasting mental and physical effects.
But as of February 1, the heroin antidote ‘Naloxone’ has been made available over the counter from pharmacists. The injectable medicine was previously only available with a prescription.
Naloxone reverses the effects of opioid overdoses by blocking the opioid from affecting the brain and nervous system, and reversing depression of the respiratory system, which causes people to stop breathing.
The move by the Therapeutic Good Administration (TGA) to reschedule Naloxone, making it available over the counter, has been welcomed by the drug reformists and medical practitioners.
The TGA received 97 submissions about the proposal to make Naloxone more easily available – every one of which agreed that the drug is safe to use, finding it has no effect on anyone without opioids in their system and has low to no potential for abuse. The TGA’s final decision was that the benefits of Naloxone outweigh any harm it might cause.
Angelo Pricolo runs a pharmacy in the Melbourne suburb of Brunswick. He spoke to the ABC’s The World Today program about what he has learned through providing an opioid replacement program to his community. Mr Pricolo said he made an application to the TGA after seeing the impact of heroin on his community and the ability for Naloxone to save lives.
“Australia will be seen as a little bit of a pioneer in this area and hopefully this decision will influence other jurisdictions to make a similar change to their drug policy,” he said.
Chief Executive of health research organisation the Penington Institute, John Ryan, cited a study which found another person (who could administer the Naloxone) was around for over half of opioid overdoses resulting in death. He said that sometimes, there was no time to wait for an ambulance or a prescription. Mr Ryan believes that if people are able to get a hold of Naloxone, it could mean the difference between life and death.
“People should always still also call an ambulance if they or someone with them is suffering from an overdose.
But increasing the availability of Naloxone beyond emergency departments and ambulances is all about trying to prevent fatal overdoses, because it is the quickest and best way to reverse the effects of an opioid overdose.”
Dr Alex Wodak is President of the Australian Drug Law Reform Foundation and recently retired from his position as Director of the Alcohol and Drug Service, St Vincent’s Hospital. Dr Wodak is not convinced that making Naloxone more freely available is the answer.
He believes there are other proven interventions that are plausible alternatives. In 2013, when the idea of making Naloxone available without a prescription gained momentum, Dr Wodak pointed out in his article published by The Conversation that:
“Although methadone and buprenorphine maintenance treatments reduce overdose deaths by about 80%, for instance, they are difficult to access in many parts of Australia.
And the payment required by patients in some programs makes them ridiculously unaffordable, especially for low-income people.
Providing more of this treatment in prison, especially for inmates close to release, is particularly important as recently released inmates have a very high rate of death from overdose in their first weeks back in the community.
But in most prisons in Australia, it is even harder to enrol in this treatment than in the community.”
Dr Wodak said more recently that while he welcomes the increased availability of Naloxone, this action does not address Australia’s problem with increased misuse of opioids. He told the Guardian that:
“Drug overdose deaths are rising at totally unacceptable levels, and while Naloxone might make some difference, getting more people who are addicted to drugs into treatment would make a much bigger difference.
Treatment is too limited in capacity and too inflexible in its design, and too much shaped by a drug prohibition environment.”
However, most agree that the increased accessibility of Naloxone is a step in the right direction when it comes to reducing deaths through heroin overdoses.