Opioid reversal - the war on drugs

Gemisha Cheemungtoo describes a drug that reverses opioids

Gemisha Cheemungtoo
18th November 2019
A new pilot scheme run by Addaction, a drug and alcohol addiction charity, will be handing out an opioid reversal drug called Naloxone on the streets of Redcar and Cleveland. The scheme will be run for 12 weeks, and Addaction intends to expand the take-home Naloxone programme across the nation.

At present, the rate of drug-related deaths in the North East have reached a record rate of 96.3 deaths per million people, compared to the lowest figure of the report, which was 39.4 deaths per million in London. Supported by Cleveland police, 'Peer to Peer Naloxone' aims to reduce the number of opioid overdose fatalities, through proactive distribution and training led by volunteers who have previously struggled with substance misuse. 

Naloxone is a strong opioid antagonist that was originally discovered in the early 1960s, but patented by the US Food and Drug Administration(FDA) by 1971. , Naloxone has made it to the World Health Organisation's (WHO) model list of essential medicines. This list itself consists of drugs WHO considers necessary to meet health care system requirements in the safest and most effective manner. It is used all over the world in medical emergencies, and can also be administered by a lay person effectively provided that they have had some training beforehand. 

Naloxone functions by competitively binding to the same µ2 opioid receptors as heroin and other opioid drugs, preventing them from re-attaching to the receptors in the central nervous system. This translates to the fast reversal of symptoms of respiratory depression, such as reduced breathing, for up to 90 minutes. This buys more time for emergency services to arrive on scene and provide help. 

According to WHO guidelines in 2014, opioid users have a 50 to 70% lifetime risk of overdosing and are highly likely to witness an overdose too. Certain people might fear the safety net of an opioid reversal drug could encourage more extreme use, however a modelling study has suggested that distribution of naloxone to 30% of heroin users may lead to a decrease in overdose deaths of around 6.6%. Within the context of the increasing rate of opioid-related fatalities, the programme could help save lives, which with further support down the line could help people overcome their addiction. 

Gary Besterfield, service manager of Addaction Redcar and Cleveland, said: “Every drug related death is a tragedy and every death is avoidable. Too many families in Redcar and Cleveland have lost loved ones. It’s time to take action."

 “The opportunity to carry and use Naloxone shouldn’t be restricted to people who are engaging in drug treatment. This is about being proactive, engaging people where they feel comfortable and saving lives.”

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