The article “Naloxone Distribution Strategies Needed in Emergency Departments” by Samuels et al (ACEP Now, March 2016) addresses the important and controversial topic of direct naloxone distribution to patients who may have an addiction to opioids. The authors recommend naloxone for patients who use heroin, exceed 100 mg of morphine equivalents daily, have opioid abuse/dependency, or have had an opioid overdose. They recommend that staff training, program monitoring, and feedback should be data driven and provided on a regular basis.
The problem of opioid addiction and related morbidity and mortality is one of increasing significance in the United States. Particularly in the ED environment, we frequently treat patients for opioid addiction and complications, including drug-seeking behavior, accidental or intentional overdose, and trauma attributable to opioid use, which may include significant morbidity and mortality.
The administration of naloxone by first responders has undoubtedly reduced deaths from opioid overdose for many years. Some also advocate for availability of naloxone to patients, family, and friends who may witness an overdose and its immediate effects. Immediate administration of naloxone can be lifesaving in such circumstances.