Naloxone in Action

At the recent American Society of Addiction Medicine (ASAM) conference, I read a poster describing a study entitled “Lives Saved with Take-home Naloxone for Patients in Medication Assisted Treatment.” The article, by Katzman et al., from the University of New Mexico School of Medicine, described the outcomes from providing naloxone overdose reversal kits to patients enrolling in medication-assisted treatment of opioid use disorders

The study subjects were admitted to medication-assisted treatment over three months in 2016. The poster didn’t say whether they started buprenorphine, naltrexone, or methadone, but I’m guessing the patients were admitted to methadone maintenance.

In the end, 244 subjects enrolled and had education about opioid overdose and how to use a naloxone auto injector kit.

Twenty-nine subjects were lost to follow up, leaving 215 subjects available for inclusion in the study. Of these 215 subjects, 184 didn’t witness or experience overdose.

That means 31 subjects either experienced or witnessed at least one opioid overdose episode.

The scientists conducting the study interviewed these 31 subjects, and discovered that 39 opioid overdoses had been reversed and all of those lives were saved. Thirty-eight people were saved with the naloxone kits distributed by the opioid treatment program, and one study subject was revived by EMS personnel.

When study authors looked at who was saved by these study subjects, they discovered 11% of people saved were acquaintances of the study subjects, 16% were family members, 58% were friends, 6% were the significant others of study subjects, and 13% were strangers.

The study authors concluded that “a significant number of lives can be saved by using take-home naloxone for patients treated in MAT [medication assisted treatment] programs.” The authors also felt the study showed that naloxone isn’t usually on the patient who entered treatment, but more frequently on friends, relatives, and acquaintances that the MAT patient encounters.

I was intrigued by this study because it mirrors what I’ve heard in the opioid treatment program where I work. We are fortunate to get naloxone kits from Project Lazarus to give to our patients. It’s rare that one of our patients enrolled in treatment needs naloxone for an overdose, but much more frequently, I hear our patients say they used their kit to save another person’s life.

If anyone doubted the abilities of people with opioid use disorders, and felt they couldn’t learn to give naloxone effectively, this study should put that idea to rest. If anyone mistaken thought people with opioid use disorders wouldn’t care enough about other people to put forth an effort to save another person, this study should put that idea to rest, too.

In fact, I’ve seen a real enthusiasm among our patients to make sure they have a kit, in case they get the opportunity to save a life. They are eager to help other people, and I find that to be an admirable attitude that’s nearly universal among the people we treat.

Sometimes I get into discussions with patients about what they think about the naloxone kits, and where they think the kits can do the most good. I’ve heard some good ideas. One patient said every fast food restaurant should have a naloxone kit, since she knew many people with opioid use disorder inject in the bathrooms of these facilities. Actually, I just an online article discussing something similar:  

This article expresses the problems that injection drug use has become for public restrooms, and makes a case for safe injection centers. This is presently illegal in the U.S.

Even Massachusetts General Hospital armed its security guards with naloxone kits, so they could give this life-saving medication to people they found who had overdosed in the hospital’s public bathrooms.

Another patient suggested giving naloxone kits to people living in trailer parks.

I know that feeds into a kind of stereotype of those who live in trailer parks, but apparently there is some basis for saying such residential areas have high density of people with opioid use disorders. It’s worth looking at.

Several patients said that all people receiving opioid prescriptions for chronic pain should also be prescribed naloxone kits, and I think that’s been recommended by many health organizations too.

Most communities have at least talked about arming law enforcement and first responders with naloxone kits, and hopefully that’s a trend that will continue to spread.

Naloxone isn’t a permanent solution for opioid use disorder, but it can keep the people alive until they can enter opioid use disorder treatment. Because dead addicts don’t recover.


7 responses to this post.

  1. Posted by Art Kelley on April 18, 2017 at 4:49 pm

    A naloxone kit for every restaurant kitchen.


  2. Posted by Matthew McClure, D.O. on April 19, 2017 at 6:50 pm

    At over 100 dollars a kit I don’t see it being placed in public places for anyone to just grab. Great that we are seeing it more and more with our first responders locally.


  3. Posted by Evie on May 18, 2017 at 5:44 am

    I don’t know at what point that quoted cost is absorbed, but I have four. I’m a methadone patient, I’m reading your blog for the first time this morning. I’ve used my naloxone kits four times, I’ve only had one used on me once and that’s​ great for more than one reason–I’m seriously allergic to narcan. I’m not turning this into a thing about possible allergies–it’s way more likely to help than hurt. Use them. Keep them around. If treated like any powerful medicine, it will help more than it hurts–respect its use–the end. I have a friend and an ex husband who are both around, and though I only talk to the friend, I’m glad of it. I don’t know the other two but I’m sure someone in the world gives a shit that they took another breath. Even if they themselves​ didn’t, it gave them another day to think about it.

    None of the aforementioned substances are going anywhere. Not the abused chemicals, the chemical antagonists, or the elements of empathy and sympathy–ephemeral substances though the latter may be. We addicts will, when it is our want, find a way tooth and nail, to get to something​. Why not put the other chemicals anywhere they can be of use? Education and medication create incredible things. There’s a whole field of science to attest to that truism.


    • Posted by Evie on May 18, 2017 at 5:49 am

      By used them four times, I do mean I’ve used four different kits and am in possession of four unused.

      Keep doing good, doc, by the way. Some of us really need MAT to wake up every day. I would love to communicate sometime. Trade views from.our different floors.


  4. Posted by Mike on October 15, 2018 at 12:22 pm

    Our local needle exchange program gives naloxone kits, along with a brief training, to anyone who asks. They don’t hear back from every recipient, but they hear back from a lot of them. It seems like this is pretty effective way to get it into the hands of those who need it most. From their experience, it would seem like active IDUs have the same ability and desire to use naloxone on overdosed loved ones, acquaintances, and strangers as those in MAT.


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