Study Boosts the Case for More Naloxone
Wider availability of the OD prevention drug would save thousands of lives—and cheaply.
A study published this week offers new evidence that it would be highly cost-effective, not to mention life-saving, to distribute Naloxone—an opioid antagonist that can reverse the effects of opioid overdose—on a larger scale. Drug ODs are currently the leading cause of accidental death in the US, and overdoses on opioids (like heroin and prescription painkillers) account for about 80% of that toll. Naloxone, which is most often injected intravenously, works by blocking opioid receptors in the brain. It's currently used by at least 183 public health programs nationwide, and they've documented over 10,000 cases of successful overdose reversals. In San Francisco, for example, where Naloxone has been distributed since the mid-'90s (with the support of the public health department since 2004), heroin OD deaths dropped from 155 in 1995 to just 10 in 2010. The next step is to make Naloxone more accessible to prescription opioid users there; overdose deaths from prescription opioids remain high, with 121 reported in 2010.
For the latest study, published in the Annals of Internal Medicine, researchers developed a mathematical model to estimate the impact of distributing Naloxone more widely to opioid drug users and their acquaintances. It shows that Naloxone can save lives cheaply. Led by Dr. Phillip Coffin, director of Substance Use Research at the San Francisco Department of Public Health, and Dr. Sean Sullivan, director of the Pharmaceutical Outcomes Research and Policy Program at the University of Washington, the researchers found that if Naloxone were available to 20% out of a million heroin users, some 9,000 deaths would be prevented over the users' lifetimes. Their basic research model, which they say uses "markedly conservative assumptions," indicates that one life would be saved for every 164 Naloxone kits handed out. More optimistic assumptions suggest that one life could be saved for every 36 kits distributed—which would prevent as many as 43,000 fatal ODs. Providing Naloxone at this level would cost about $400 for every year of life saved—a figure considerably below the standard $50,000 cut-off for medical interventions. That's also cheaper than most accepted prevention programs in medicine, such as checking blood pressure or smoking cessation. "Naloxone is a highly cost-effective way to prevent overdose deaths," says Dr. Coffin. "And, as a researcher at the Department of Public Health, my priority is maximizing our resources to help improve the health of the community."