Adding Naloxone to Prevention Programs Reducing Fatalities

Nearly 40,000 Americans died from drug overdoses in 2010, the 11th consecutive year the number of fatalities increased. A Centers for Disease Control and Prevention report issued earlier this year said the steady rise started with 16,849 deaths in 1999.

More than half of the overdose deaths in 2010 involved prescription drugs. Of those, opioids played a role in 75 percent (16,651) of fatalities. Developing programs to reverse that trend will be discussed during Course 7, “Implementing Overdose Death Prevention Programs With Naloxone,” at 2 pm today in Continental B at the Hilton Chicago.

The course will help addiction treatment providers implement overdose prevention services with naloxone in their programs said Sharon Stancliff, MD, Medical Director of the Harm Reduction Coalition, New York. It will include a summary of the epidemiology of overdose, a review of the literature on the feasibility and efficacy of naloxone programs, and the tools for evaluating the regulatory environment in different states. Participants will learn how to prescribe naloxone to their patients and how to train patients and colleagues about overdose prevention and naloxone.

At least 17 states have passed legislation or initiated pilot programs that allow people at risk of witnessing a drug overdose—including drug users, and the parents and spouses of drug users—to carry and administer naloxone to someone suffering an overdose. Nearly a dozen other states have similar legislation pending, she said.

“It’s spreading like wildfire,” Dr. Stancliff said. “It’s happening incredibly fast. Different states will have different ways of implementing it. It’s on the road to becoming a standard of care. Providers need to understand what is happening in their state. Should this be in your treatment program?”

Alex Walley, MD, Medical Director of the Massachusetts Department of Public Health’s Opioid Overdose Prevention Pilot, will present the course with Dr. Stancliff. The number of opioid-related deaths in Massachusetts increased from less than 100 a year in the 1990s to more than 600 a year by the mid-2000s, he said.

“We have more overdoses than traffic accident fatalities in Massachusetts,” Dr Walley said. “It’s the leading cause of accidental death in Massachusetts.”

Inspired by the work Dr. Stancliff and others were doing in New York—as well as programs in Chicago and San Francisco—Massachusetts implemented a naloxone program in Boston and Cambridge in 2006, and the program has been expanded to over 14 communities. More than 17,000 people have been trained to use a naloxone rescue kit, and 1,700 rescues have been documented, Dr. Walley said.

“Overdose is the No. 1 killer of people with addiction, and overdoses are increasing,” he said. “We don’t have many tools to address it. Educating patients about overdoses and giving them rescue kits is one innovative and promising intervention we can do.”