Naloxone Is Just One Piece of the Opioid Puzzle

What Else Is Needed

Any comprehensive solution to this nationwide crisis must be three-pronged: ending the initiation of patterns of hyperalgesia, abuse, and addiction; preventing harm to allow treatment access; and restoring normalcy to the lives left tattered through treatment initiatives. Recovery programs aim to provide long-term stability through social support systems or, more successfully, evidence-based medication-assisted treatment programs. However, the reality is that those with opioid use disorder are constantly at risk of overdose, whether due to a highly potent or adulterated illicit supply, loss of tolerance during abstinence or treatment, or an attempt to pursue the elusive “next best high.”

Naloxone is a drug with the ability to save lives in the hands of bystanders. But it is just one piece of the puzzle, and the long-term consequences of this public health initiative are still unknown. Additionally, the adverse effects have been understated and the benefits overstated. If we are to address this epidemic realistically, we need to be honest about the tools we have at our disposal. Naloxone is just the beginning of the answer to the opioid epidemic. We can manage precipitated opioid withdrawal and cannot resuscitate someone who has died, but real solutions to prevent death in those with opioid use disorder include expanding harm reduction efforts; implementing medication-assisted treatment programs; connecting patients to support programs; and being mindful of how powerful a compassionate, nonjudgmental, nonstigmatizing, and supportive system can be to the health of our patients.

Mr. Lozo is a medical student at Rutgers New Jersey Medical School in Newark.

Dr. Nelson is chair and professor in the department of emergency medicine at Rutgers New Jersey Medical School.