Drug overdose is one of the major causes of preventable injury and deaths among all age groups. With the rapid rise in overdose deaths in recent times, the importance of prescribing naloxone, the antidote for drug overdose, has been recognized by the governments of approximately 28 states in the United States.
Moreover, it is now increasingly provided to patients in an effort to tackle the opioid crisis. The medical practitioners and experts, now highly realize that the permission to the emergency medical services (EMS) staff to administer naloxone can drastically reduce the burden of overdose deaths. The timely intervention using naloxone can definitely turn out to be lifesaving.
It is a cause of concern that unintentional overdose from opioid analgesics is a leading reason for injury-related death in the U.S. If we look at the statistics, an alarming 91 Americans die due to an opioid overdose every day, yet, the sale of opioids continues to rise. Since 1999, the total number of overdose deaths due to prescription opioids and heroin in the U.S. has nearly quadrupled.
Naloxone is a medication that can rapidly reverse an opioid overdose. It works by binding to opioid receptors and therefore can reverse and block the effects of other opioids. It acts quickly to restore the normal respiration in a person whose breathing has slowed or stopped due to overdosing on heroin or prescription pain medications.
Though naloxone is an extremely safe medicine, it has the potential to cause a range of withdrawal symptoms, such as nausea, vomiting, diarrhea, stomach pain, fever, sweating, body aches, fast heart rate, throbbing heartbeats, increased blood pressure, nervousness, restlessness, irritability, goose bumps, shivering, etc. The withdrawal symptoms may be uncomfortable but not life-threatening.
A research funded by the National Institute on Drug Abuse (NIDA) found that patients who were coprescribed naloxone along with opioids to treat long-term chronic pain in a primary care setting had 63 percent fewer emergency department (ED) visits for opioid-related emergency after one year in contrast to those who were not prescribed naloxone.
This study proves that naloxone may be coprescribed with opioids to primary care patients after prioritizing those who are at a higher risk, as it reduces opioid-related hazardous events. It could be made available to even those who are picking up opiate prescriptions on behalf of family members as most overdoses happen at home or when family members are close by. The broad access to naloxone in pharmacy settings will give the opportunity to the users to keep themselves and their family members safe without feeling stigmatized.
Although there are huge benefits associated with coprescribing naloxone to patients with chronic pain, many clinicians have also identified several potential barriers, including the lack of training among clinic staff and the fear of offending patients who could associate this with being stigmatized by being perceived as having an opioid addiction.
However, such fears of offending patients are unfounded. A study aimed at gauging the attitudes of chronic pain patients in primary care setting when offered a naloxone prescription established that it was largely acceptable to them. Around 97 percent of the respondents believed that naloxone should be coprescribed with the opioid painkillers. The study also reported positive behavioral changes, such as responsible use of opioids among 37 percent after receiving a naloxone prescription.
The wide scale access to naloxone in pharmacies has the potential to save many lives across both rural and urban realms of the society. In order to reduce fatalities due to opioid abuse, medical care providers and clinical staff should receive mandatory training on how to prescribe naloxone. Since the term overdose may not indicate patients’ perception of the event, the terminology should change to poisoning. However, the core is receiving immediate treatment in the advent of any addiction or overdose.
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