1. INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Naloxone could save so many lives but is
restricted to so few
Preliminary results of the IDHDP global
naloxone survey
Dr Chris Ford, Clinical Director
Vanessa Huke, Communications Manager
IDHDP
Global Addiction Conference Belgrade
Physicians globally unite for health based drug policy
2. Reducing drug related deaths:
Naloxone part of the solution
Saved my life But many have
been lost
Siobhan’s story
5. Why we need naloxone
• 1.3 million users of opioids in Europe
• 27 million users of opioids worldwide (0.6%
world pop)
• 6,100 overdose deaths in Europe in 2012
• 3.5% of all deaths in males under 40 in Europe
• 250,000 overdose deaths world wide in 2010
This represents 2 million years of life lost
Preventing opioid overdoses in Europe EMCDDA, Lisbon,
October 2012 (revised 2014)
6.
7. What is Naloxone?
• An opioid receptor antagonist
• Reverses opioid (heroin, methadone, prescription
opioids) overdoses
• Safe, cost-effective
• Can be given
– IV, IM, subcutaneous, intranasal
Images from www.noperi.org 2015
8. Opiate overdose
Most heroin users
witness/experience an
overdose at some point:
From a sample of 155
drug using clients:
– 46% had overdosed
themselves
– 82% had witnessed an
overdose
– 43 of which were fatal
46%
82%
43
Best D., Man LH., Gossop M., Noble A., Strang J., 2000
9. Naloxone is just part of a response
Naloxone is an addition
to a greater set of
overdose interventions,
you should still:
– Check ABC
– Ambulance – call
– Breathing
– reCovery position
– Stay with them
10. What reduces risk of fatal overdose?
Better response to opiate overdose and
wider access to take home naloxone.
11. Talking about Naloxone:
United Nations Commission on Narcotic Drugs
UNODC 2012
Resolution 55/7:
“Encourages all Member States …..to share best
practices ………..including the use of opioid
receptor antagonists such as naloxone”
http://www.unodc.org/documents/commissions/CND/Drug_Resolutions/2010-2019/2012/CND_Res-55-7.pdf
12.
13. Compare England with Scotland & Wales: Shocking rise in number of deaths
registered in 2013
(Office of National Statistics: 2014)
0
200
400
600
800
1000
1200
1400
1600
1800
2000
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
numberofdrugrelateddeaths
Number of “drug misuse” Deaths 1993-2013
England
Wales
Scotland
14. Barriers
• Legal restrictions
• Bad policy
• Ignorance
– “Naloxone is a drug of abuse”
– “Naloxone is dangerous”
– “Naloxone will encourage risk taking”
• Lack of Awareness
• Lack of Motivation
– Need local champions
15. What do we know about Naloxone in
2013?
o Denmark, Germany, Italy, Romania, United
Kingdom, Afghanistan, Australia, Canada, China,
India, Italy, Kazakhstan, Kyrgyzstan, Tajikistan,
Thailand, United Kingdom, United States,
Ukraine and Vietnam report the existence of
naloxone programmes
o The measure is regarded as a low-cost
approach that can empower healthcare
workers and people who use drugs to save
lives
http://www.emcdda.europa.eu/topics/pods/preventing-overdose-deaths 2013
16. Countries which have Naloxone
Counries with naloxone
Counries without
naloxone
No data
17. Question 1: Location of Participants
With members in over 80 countries the survey had responses from
21 of these countries
18. • Q2 Is there a problem with opioid related
overdose in your area?
19.
20.
21.
22.
23.
24.
25.
26.
27.
28. INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Now - go out and
SAVE SOME NALOXONE
Also complete the survey
Dr Chris Ford & Vanessa Huke
chris.ford@idhdp.com
www.idhdp.com
Physicians globally unite for health based drug policy
29. INTERNATIONAL DOCTORS FOR HEALTHIER DRUG POLICIES
Tuesday 2nd June @ 1740
“If doctors want to treat addiction - they
should start with the policies”
Why WE ALL need to be involved with the
UNGASS debate
All welcome
FOLLOWED BY IDHDP MEMBERS MEETING @ 1830
Physicians globally unite for health based drug policy
Editor's Notes
1
Siobhan’s story
Rise in deaths
UK = 5th highest rate in EU of deaths/million population. Mortality due to drug-induced deaths in EU, Croatia, Turkey and Norway (European Monitoring committee for Drugs and Drug Addiction 2013)
Comment re intranasal
The sample of drug using clients was from a study in South London in 2000
But don’t forget naloxone is only part – remember A, B and C
And D don’t panic
Temporarily reverses the effects of an opiate overdose
No effect on overdoses resulting from the use of other drugs
Short acting - can begin to wear off in 20 mins
Overdose can last for 8 hours or more (especially with methadone)
Only for use with continued medical support – still need to ring 999 (buys time)
No potential for abuse
Naloxone precipitates WITHDRAWAL – the individual may want to use again straight away/ become aggressive.
WHO recommendation: November 2014
“People likely to witness an opioid overdose should have access to naloxone
and be instructed in its administration to enable them to use it for the emergency management of suspected opioid overdose.”
http://www.who.int/substance_abuse/publications/management_opioid_overdose/en/
