Over the past 25 years, naloxone has emerged as a critical lifesaving overdose antidote.
Public health advocates and community activists established early methods for naloxone
distribution to people who inject drugs, but a legacy of stigmatization and opposition
to universal naloxone access continues to limit the drug's full potential to reduce
opioid-related mortality. The establishment of naloxone distribution programs under
the umbrella of syringe exchange programs faces the same practical, ideological and
financial barriers to expansion similar to those faced by syringe exchange programs
themselves. The expansion of naloxone from the confines of a few syringe exchange
programs to what we see today represents an enormous triumph for the grass-roots activists,
service providers, and public health professionals who have fought to guarantee lay
access to naloxone. Despite the extensive efforts to expand access to naloxone, naloxone
continues to remains a scarce resource in many US localities. Considerable naloxone
“deserts” remain and even where there is naloxone access, it does not always reach
those at risk. Promising areas for expansion include the development of more robust
telehealth methods for naloxone distribution, including subsidized mail delivery programs;
lowering barriers to pharmacy access; working with hospitals, ambulances, and law
enforcement to expand naloxone “leave behind” programs; providing naloxone co-prescription
with medications for opioid use disorder; and working with prisons, shelters, and
networks of people who use drugs to increase access to the lifesaving medication.
Efforts to ensure over-the-counter and low- or no-cost naloxone are ongoing and stand
alongside medication-assisted treatments as efficacious, readily-actionable, and cost-efficient
population-level interventions available for combatting opioid-related overdose in
the United States.
Abbreviations:
CDC (Centers for Disease Control and Prevention), DEA (Drug Enforcement Agency), EMS (Emergency Medical Services), FDA (Food and Drug Administration), MOUD (Medications for Opioid Use Disorder), NIMBY (Not in My Back Yard), OD (Overdose), OEND (Overdose Education and Naloxone Distribution), OUD (Opioid Use Disorder), PO (Prescription Opioids), PWID (People Who Inject Drugs), PWUD (People Who Use Drugs), PWUO (People Who Use Opioids), SCF (Safe Consumption Facilities), SEP (Syringe Exchange Program), SSP (Syringe Service Program), THN (Take Home Naloxone), US (United States), VA (Veterans Administration)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 05, 2021
Accepted:
March 1,
2021
Received in revised form:
February 28,
2021
Received:
January 7,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
