Heroin overdose: the case for take-home naloxone.

Abstract

Non-fatal overdose is an occupational risk of heroin misuse1 and fatal overdose is a common cause of premature death in heroin users.2 3 4 One of the major contributors to a fatal outcome is the inadequacy of heroin users' responses to the overdoses of their peers. They may delay calling an ambulance for fear of the police arriving, and their efforts to revive comatose users are often ineffective. The distribution of naloxone to opiate users was first mooted in 19925 as an intervention that would be life saving in such situations.6 With a rising toll of deaths from heroin overdose it is time to take the suggestion seriously. Interviews with 320 heroin users in Sydney found that two thirds had had a drug overdose, a third within the past year, and that 80% had been present at the overdose of another user.7 In Australia the incidence of deaths from heroin overdose has increased over the past decade while deaths from other drug related causes have fallen. In the United Kingdom a sharp increase in the numbers of deaths among opiate users has recently been …