{"id":768,"date":"2012-06-01T00:00:21","date_gmt":"2012-06-01T07:00:21","guid":{"rendered":"http:\/\/rhochistj.org\/RCP_TEST\/?p=768"},"modified":"2014-02-17T16:26:33","modified_gmt":"2014-02-17T23:26:33","slug":"naloxone-distribution-programs","status":"publish","type":"post","link":"https:\/\/rhochistj.org\/RhoChiPost\/naloxone-distribution-programs\/","title":{"rendered":"Naloxone Distribution Programs"},"content":{"rendered":"

By: Mahdieh Danesh Yazdi, Associate Student Editor, <\/span>with\u00a0<\/em>Special Thanks to Dr. Tomasz Jodlowski for his contributions to this article<\/i><\/p>\n

–<\/p>\n

In the 1990s, major urban and rural areas across the United States grappled with a common problem: drug addiction.\u00a0 At that time, the drugs of choice were illicit substances (i.e. heroin).\u00a0 In order to combat the overwhelming number of deaths due to overdose of these drugs, many cities began using naloxone distribution programs.\u00a0 Naloxone (Narcan\u00ae) is a short-acting mu<\/i> receptor antagonist used in cases of opioid overdose.\u00a0 It works by competing with opioids at mu<\/i> receptors, thus, preventing them from exerting their pharmacological effects, the most dangerous being respiratory depression.\u00a0 Since most abused drugs, whether illicit or prescription, are derived from opioids, naloxone plays a life-saving role for many patients addicted to these drugs.\u00a0 Naloxone (Narcan\u00ae) essentially reverses opioid activity and allows the patient to breathe again.<\/p>\n

When initiating the program, it was hoped that with these naloxone kits, people near an addict would recognize the onset of symptoms and be able to inject the addict with the life-saving drug.\u00a0 This is a harm-reduction strategy, where a public health organization tries to reduce the consequences of harmful behavior such as drug abuse, as opposed to stopping the behavior itself.\u00a0 Chicago pioneered the movement, and it has since spread to other major cities, including: Milwaukee, Los Angeles, Boston, Baltimore, New York City, New Mexico, and San Francisco.\u00a0 These programs also exist in other countries, such as Canada and Australia.<\/p>\n

Such strategies have many opponents.\u00a0 They argue that these programs encourage people to continue their addictive behavior because it gives them a false sense of security about the negative consequences of their behaviors.\u00a0 This, they claim, encourages further drug abuse.\u00a0 The federal government is among these skeptics, and it has openly stated its opposition to the implementation of such programs.\u00a0 Proponents argue that these programs are effective in reducing the number of deaths due to drug abuse and that they do not increase the incidence of addiction.<\/p>\n

However, with the current increase in drug abuse, specifically prescription drug abuse, these programs are once again relevant.\u00a0 Prescription drugs recently superseded illicit substances in the number of addicts and deaths related to overdoses.\u00a0 According to the Centers for Disease Control (CDC), in 2007, over 12,000 people died of prescription drug overdoses.\u00a0 In fact, prescription drug abuse accounted for more death than heroin and cocaine combined.\u00a0 This is especially true for rural areas, where people are twice as likely to overdose versus city residents.\u00a0 With less access to immediate medical care, naloxone kits may be the best chance some individuals have to survive.<\/p>\n

For example, in Scott County, Indiana, prescription narcotics are the new drugs of choice for abuse.\u00a0 In this small town with a population of 24,000, nine people have died this year alone from prescription drug overdose.\u00a0 Naloxone kits may prevent such deaths, as they have in large cities. A study assessed the naloxone distribution program in New York City.\u00a0 About 82 participants stated that they had used naloxone: 68 overdose patients survived and the fate of 14 others was unknown.\u00a0 This data can help public health officials make the case for implementing and expanding naloxone distribution programs.<\/p>\n

Despite promising results, there are limitations to such programs. The cost of the drug, clean syringes, and educating addicts place a burden on organizations responsible for these programs; a burden some may not be able to bear. These concerns are further exacerbated by the current economic climate which puts pressure on state and local municipalities to cut back on all programs. Also, as with any injectable drug, there is always the potential for infection if the medication is not properly used, mandating additional training for all those receiving vials.<\/p>\n

It is important to note that the effectiveness data of these programs is not clear-cut.\u00a0 A meta-analysis of medical literature reviewing these programs from 1990 to 2004 revealed that there is not enough evidence to support a decrease in mortality with the use of these medications.\u00a0 Most data on the issue is anecdotal.\u00a0 Further research and experimental studies are required to prove that naloxone distribution programs are actually effective, particularly in terms of the one major endpoint that matters: saving patients\u2019 lives.<\/p>\n

\u00a0<\/span><\/b><\/p>\n

SOURCES:<\/span><\/b><\/p>\n

    \n
  1. Baca CT, Grant KJ.\u00a0 Take-home naloxone to reduce heroin death.\u00a0 Addiction.\u00a0 <\/i>2005 Dec;100(12):1823-31.<\/li>\n
  2. Centers for Disease Control and Prevention.\u00a0 CDC Grand Rounds: Prescription Drug Overdoses \u2014 a U.S.\u00a0 Epidemic.\u00a0 Website.\u00a0 Available online: http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6101a3.htm<\/a>.\u00a0 Jan 13, 2012.\u00a0 Accessed Apr 23, 2012.<\/li>\n
  3. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report: Community-Based Opioid Overdose Prevention Programs Providing Naloxone \u2014 United States, 2010. Website. Available online: http:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6106a1.htm<\/a>. Feb 17, 2012.\u00a0 Accessed May 23, 2012.<\/li>\n
  4. Piper TM, Stancliff S, Rudenstine S, et.al.\u00a0 <\/i>Evaluation of a naloxone distribution and administration program in New York City.\u00a0 Subst Use Misuse.\u00a0 <\/i>2008;43(7):858-70.<\/li>\n
  5. Wisniewski M.\u00a0 Painkiller Opana, new scourge of rural America.\u00a0 Website.\u00a0 Available online: http:\/\/www.reuters.com\/article\/2012\/03\/27\/us-drugs-abuse-opana-idUSBRE82Q04120120327<\/a>.\u00a0 Mar\u00a0 27, 2012.\u00a0 Accessed: Apr 25, 2012.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    By: Mahdieh Danesh Yazdi, Associate Student Editor, with\u00a0Special Thanks to Dr. Tomasz Jodlowski for his contributions to this article – In the 1990s, major urban and rural areas across the United States grappled with a common problem: drug addiction.\u00a0 At that time, the drugs of choice were illicit substances (i.e. heroin).\u00a0 In order to combat…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7,4,5],"tags":[343,627,2243,1160,15,13,2229,2227,29,129,314,20,137,315,14,646,210,363,968,1625,19,2260,184,42,1820,31,1736,185,1679,33,21,2252,1003,225,1061],"class_list":["post-768","post","type-post","status-publish","format-standard","hentry","category-clinical","category-featured","category-news-politics","tag-and","tag-breathe","tag-cdc","tag-control","tag-disease","tag-drug","tag-drugs","tag-ebola-virus-disease","tag-editor","tag-epidemic","tag-for","tag-health","tag-infection","tag-injectable","tag-medication","tag-naloxone","tag-note","tag-of","tag-one","tag-or","tag-patient","tag-pressure","tag-problem","tag-public","tag-reduction","tag-research","tag-respiratory","tag-scourge","tag-short","tag-student","tag-study","tag-symptoms","tag-tm","tag-weekly","tag-with"],"views":729,"_links":{"self":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts\/768","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/comments?post=768"}],"version-history":[{"count":0,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/posts\/768\/revisions"}],"wp:attachment":[{"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/media?parent=768"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/categories?post=768"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rhochistj.org\/RhoChiPost\/wp-json\/wp\/v2\/tags?post=768"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}