Calls for wider distribution of Naloxone in the UK

http://www.guardian.co.uk/politics/2009/sep/13/naxalone-heroin-overdose-miracle-drug

Plea to ease curbs on 'miracle' heroin drug Naxalone, used to revive users who have overdoses

Some fear proposals could encourage riskier habits

Denis Campbell, health correspondent guardian.co.uk

Sunday 13 September 2009 22.05 BST

The government's advisers on illegal substances want curbs eased on a controversial "Lazarus" drug that reverses heroin overdoses, in an effort to cut the rising death toll among addicts.

When a heroin user has an overdose, one injection of naloxone revives them from unconsciousness and gives them enough time for medical help to arrive. It is already used by ambulance crews, casualty staff and out of hours GPs faced with someone who has taken a potentially fatal dose of heroin or another opiate.

The Advisory Council on the Misuse of Drugs, the body that advises the Home Office, is pushing for naloxone to be made much more widely available so that people working with the UK's estimated 300,000 heroin addicts can stock it.

The ACMD has asked the Medicines and Healthcare Products Regulatory Agency, the government's medicines watchdog, to allow frontline drugs workers, managers of hostels for the homeless and other staff who may witness an overdose to retain and inject the drug.

In a letter to the MHRA, Prof Les Iversen, chair of the ACMD's technical committee, said the National Treatment Agency for Substance Misuse (NTA)'s decision to let 950 relatives and carers of heroin addicts be trained in using naloxone "represents a step forward in tackling the high number of fatal opiate overdoses".

He adds: "We consider that provisions should be extended to cover others who may be in contact with drug users through their work."

Iversen, a professor of pharmacology at Oxford University, has hailed naloxone as "a miracle drug in terms of opiate overdoses" that could save 500 heroin users from dying every year. It might have saved singer Michael Jackson's life if it had been administered after his overdose, he believes.

However, doctors and drugs experts are divided about proposals to make naloxone more readily available.

Some fear that it could encourage users to indulge in even riskier drug-taking. Others have warned that up to 3% of those receiving naloxone suffer potentially life-threatening side-effects ‑ and even that it can be used as a weapon in fights between users.

But interest in naloxone as an antidote and potential lifesaver is growing, especially following the most recent annual statistics for deaths from all types of drugs that showed they rose by 11% to 2,928 in 2008 – the highest figure since 2001.

The Medical Research Council hopes to give the drug to 58,000 heroin users who have recently been released from prison as a way of examining its advantages and disadvantages, and a £1m pilot project research project involving 5,800 ex-inmates is due to start soon.

Prof John Strang, one of those behind the MRC's move, said: "The downsides of naloxone are very little. It's not pleasant, because it induces almost instantaneous cold turkey, but it saves lives."

The NTA's director of delivery, Rosanna O'Connor, said: "Naloxone forms part of the government's harm reduction and overdose prevention strategy. The government recognises the life-saving potential of naloxone and supports its use in a number of settings."