Overdose reversal drugs made available for users in Dublin under new scheme

Drug users in Dublin can take home potentially life-saving overdose reversal drugs for the first time under a scheme operated by the Health Service Executive (HSE) and St James’s Hospital.

The pilot initiative provides free naloxone kits to patients attending the hospital’s emergency department who have experienced, or are at risk of, an opioid overdose. Naloxone is a semi-synthetic drug that prevents opioids from binding to receptors in the brain and body, and reverses breathing restrictions that can cause death.

Although available on a take-home basis in other countries, St James’s Hospital has become the first hospital in Ireland to promote the product.

The Nalox-Home initiative, launched on Thursday to mark International Overdose Awareness Day, involves a brief awareness intervention for patients on discharge from the emergency department or after an inpatient admission. Central to the project, however, is the prescription and provision of take-home naloxone.

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Opioids were implicated in seven out of 10 poisoning deaths identified by the Health Research Board in 2020, when Ireland experienced 409 overdose poisoning deaths. In more than half of cases the victim was accompanied by someone who could have administered naloxone.

“We wouldn’t hesitate to provide an EpiPen to someone with a severe allergy or a glucagon injection to a diabetic at risk of severe hypoglycaemia,” said Jess Sears, inclusion health clinical nurse specialist at St James’s Hospital. “We should follow the same approach for opioid users by training their family and friends on how to identify an emergency and respond.”

Ms Sears said Ireland should also follow Scotland’s lead in allowing the drug to be available through the ambulance service, gardaí and other emergency responders.

[ New initiative by Irish Prison Service aims to combat opioid overdoses ]

It is hoped the pilot scheme could improve the relationship between hospital staff and patients, potentially encouraging them to return for follow-up care.

Prof Eamon Keenan, HSE national lead for addiction services, said it was hoped that awareness interventions and providing take-home naloxone would save lives, reduce stigma and support harm reduction from drugs.

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An article in the journal Drugnet reported that in 24 EU member states that responded to its research, naloxone was available on medical prescription in 13 and limited to hospital-only prescription in 11. While none had a national take-home programme in 2016, the year of its research, programmes existed in cities or regions across Europe. Elsewhere, it said, take-home naloxone programmes were available in the US, Australia, Canada and Russia.