Australian researchers say access to a free medicated nasal spray which temporarily reverses the effects of opioid toxicity while waiting for an ambulance to arrive, will save lives and reduce opioid-related hospital admissions.
The Federal Government is funding a national Take Home Naloxone (THN) program which makes the life-saving medication available for free and without prescription in pharmacies across Australia.
Naloxone reverses the effects of opioid toxicity and, under the THN program, is available from pharmacies for anyone at risk of either experiencing or witnessing an opioid overdose or adverse reaction.
Initially introduced on a trial basis, the THN program has expanded to now include more than 384 participating pharmacies across South Australia.
Dr Victoria Cock, Statewide Clinical Director, Drug and Alcohol Services SA, says demand for free naloxone is growing as more people become aware of its availability, with 8377 units being supplied across South Australia (SA) alone in 2022-23 and 16,171 in 2023-24.
A recent paper co-authored by SA Health experts and University of South Australia pharmacist Dr Jacinta Johnson found there were 2046 hospital admissions in SA involving opioid toxicity between 2017 and 2020, costing the State approximately $18 million.
Almost 20% of the patients admitted stayed in hospital for more than five days, 22% required intensive care and around 10% required mechanical ventilation.
Of the 2046 opioid toxicity-related admissions in SA hospitals, 6% involved children who were accidentally poisoned, prompting health officials to remind South Australians about the importance of safe medication storage and disposal of opioids to protect children.
Families also may wish to consider having naloxone on hand in case of an accidental poisoning at home.
Members of the public can locate their nearest registered pharmacy using the user-friendly map available on www.sahealth.sa.gov.au/naloxone. They do not need to provide any identifying details when requesting naloxone at a pharmacy. The webpage also includes a range of resources consumers may find useful.
Dr Maria Sarantou from Flinders Medical Centre says a 2019 trial of the Take Home Naloxone (THN) program, providing free access to the opioid blocker, found that it saved an estimated three lives a day.
“Research evaluating the pilot program showed that expanding THN supply to include the majority of patients prescribed medium to high doses of opioids would save hundreds of lives over the next five years,” Dr Sarantou says.
Dr Johnson, the UniSA senior lecturer who is responsible for driving all pharmacy research across SA Health, says a history of opioid toxicity is a major risk factor for future overdoses, yet many patients were not referred to drug and alcohol services or specialist pain services for help after discharge.
“There are things within the system we can improve,” Dr Johnson says.
In addition to the now implemented THN program, which is expanding to include an increasing number of public hospitals, the authors have made the following recommendations:
- Improved discharge referrals to external healthcare services; and
- Parental/carer education around safe storage and disposal of opioids to protect children.
Organisations involved in the study included local health networks in Adelaide, South Australian Statewide Chronic Pain Clinical Network, University of South Australia, University of Adelaide, and SA Pharmacy Statewide Clinical Support Services.
“A 3-year retrospective review of hospital admissions involving opioid toxicity in South Australia” is published in Drug and Alcohol Review. DOI: 10.1111/dar.13913
Background
Naloxone is a drug that can temporarily reverse the effects of opioid toxicity, which may be referred to as an opioid overdose or adverse reaction. If someone is experiencing severe opioid toxicity, they may be unconscious or awake, but unable to talk. It’s unlikely they will be able to administer naloxone themselves.
Naloxone can be administered by injection into a muscle or delivery through a nasal spray. It works by blocking opioid drugs, such as heroin and oxycodone, from attaching to opioid receptors in the brain.
It is vital to call an ambulance (000) as naloxone’s effect only lasts about 30-90 minutes and the person can experience toxicity again once it wears off.
Opioids include pharmaceutical opioids, that is, medicines used for pain, and non-pharmaceutical opioids, such as heroin. The average Australian drug-related death last year involved a middle-aged person who was taking prescribed pharmaceutical opioids in combination with other prescribed pharmaceutical drugs.
