Naloxone: A way back from an opioid overdose
That’s the message government agencies and medical societies are broadcasting as they strengthen calls to increase access to this prescription drug, known as an opioid antagonist. Naloxone counters the effects of opioids and can reverse an opioid overdose in minutes.
Opioid abuse and death from overdose remain a critical healthcare issue in the U.S. A recent Modern Healthcare article reports that opioid abuse has trended downward recently, though opioid-overdose death rates have risen from 2003 to 2013.
Both the Food and Drug Administration (FDA) and the U.S. Department of Health and Human Services (HHS) convened meetings this year centered on increasing naloxone access nationwide. Nearly 200 experts at the two-day FDA meeting in July discussed topics that included ensuring EMTs and police carry naloxone and prescribing the medication alongside high-potency opioid painkillers (a practice called “co-prescribing”).
“The importance of co-prescribing and third-party prescribing cannot be understated,” said Dr. William Morrone, an addiction expert and member of the American Society of Addiction Medicine (ASAM), at the FDA meeting.
We need to expand access to this life saving drug.”
According to ASAM, 21 U.S. states and the District of Columbia have laws regarding the use of opioid antagonists, like naloxone, for preventing opioid overdoses. These include measures that allow individuals other than EMTs and ER staff, such as family members, to administer drugs like naloxone to combat an opioid overdose.
The American Medical Association (AMA) has also made clear the importance of naloxone. In a statement released in September, AMA Board of Trustees Chair-elect Dr. Patrice Harris describes co-prescribing naloxone as a critical part of the solution to the rising epidemic of opioid-overdose related deaths.
“Increased access to naloxone is a key element of a comprehensive public health approach to decrease prescription drug overdose,” Dr. Harris writes.
Earlier this year, the HHS announced $1.8 million in grants to support rural U.S. communities’ efforts to cut opioid overdose and death rates. The money will pay for purchasing naloxone, training healthcare professionals and first responders, and increased substance abuse treatment.
Progress has recently been made in this regard. The Centers for Disease Control and Prevention report that the number of organizations providing naloxone kits almost doubled from January 2013 to June 2014. From 1996 to 2014, more than 26,000 overdoses were prevented after naloxone was administered.
Opioids are widely used painkillers, but dosing must be carefully monitored due to their addictive qualities. Many patients become addicted to opioids while in the hospital and resort to illicit means to get painkillers once their prescription runs out. Government and private institutions are pushing for changes in opioid prescribing to help combat this trend, including greater access to substance abuse treatment and prescription drug monitoring programs.
Prescribers can also potentially help curb trends and reduce accidental overdoses by being aware of the pharmacogenetic considerations surrounding opioid medications. Precisely dosing opioid medications can be difficult because many are processed by the highly variable CYP450 family of enzymes, which means other drugs within a patient’s regimen and the patient’s own genetics may influence the opioid’s efficacy. These factors can, in turn, lead to accidental overdosing.
To learn more about genetically-caused opioid interactions, visit http://genelex.com/clinical-guidance/pain/.