Pre-provision of emergency naloxone: Major achievements but substantial challenges remain

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Pre-provision of emergency naloxone: Major achievements but substantial challenges remain

25 November 2015
John Strang

Nearly 20 years ago, it was first proposed that take-home naloxone should be provided to heroin/opioid users themselves, to their family members and to other carers. In the intervening years, the field has been progressively explored. Influential studies and local early adoption have shaped the development of this initiative, but the full life-saving potential of the approach has not been properly harnessed. In recent years, key milestones there have been pioneering initiatives of large-scale naloxone provision.

Recent research studies have strengthened the evidence base, and influential guidance from United Nations, World Health Organisation and for national governments have paved the way for major implementation. However obstacles still exist, such as the reliance on injectable formulations, slowness of the industry to develop non-injectable naloxone, and nervousness and ambivalence from commissioners about this additional harm reduction intervention. Future developments that require serious consideration include proper study of potential non-injectable naloxone (such as potential nasal spray), widespread pre-provision as a public health strategy, and adoption of a policy of presumption of universal provision to relevant patent population.

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