TITLE:
The Place of Community Rescue Naloxone in a Public Health Crisis of Opioid Overdose
AUTHORS:
Joseph V. Pergolizzi, Jo Ann LeQuang, Robert Taylor, Robert B. Raffa
KEYWORDS:
Opioid Crisis, Opioid Abuse, Opioid Antagonist, Community Naloxone
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.10 No.2,
February
1,
2019
ABSTRACT:
The recent large increase in deaths
involving opioids (whether prescription or illicit, pure or adulterated, alone
or in combination with other drugs) is the manifestation of a complex, and multifaceted problem
consisting of psychological, psychosocial, medical, legal, regulatory,
economic, cultural, and political components, among others. Because the problem
involves issues related to both supply and demand, the solution is not obvious,
simple, or quick. There is no easy fix. Preventing and treating opioid misuse
and abuse requires a comprehensive, time-intensive, and expensive intervention
supported by public policy and support through coordinated medical, regulatory,
legal, and financial guidelines and practice. But until the long-term problems
can be fixed, the immediate crisis of overdose deaths can be ameliorated by
making available an opioid receptor antagonist to reverse the respiratory
depression that is the cause of death to those who are in the best position to
administer it in time (professionals, untrained bystanders, and even fellow
drug abusers). The statistics overwhelmingly demonstrate that this is a
life-saving medical intervention. Yet, there is still uncertainty about this
intervention, and even some opposition to it. We describe the scientific basis
for the approach and the issues surrounding its use to treat accidental or
intentional overdose by pain patients, recreational opioid users, and addicts.
We also describe the calls to limit the number of times it should be available
to a user and the limitations of its effectiveness—mainly that it only
addresses the acute death crisis, not the underlying problems that led to it.