The Pharmaceutical Journal Vol 264 No 7089 p469
March 25, 2000 Letters

Medicines legislation

Administering naloxone

From Mrs D. K. Roberts, FRPharmS

SIR,-I would like to add my support to Dr John's contention that there is an urgent need to review that section of the Medicines Act which relates to the administration of parenteral products in an emergency.¹
The opiate antagonist naloxone is another important omission from the list of exempted drugs that can be administered for the purpose of saving life in an emergency. It is, however, included in the list of drugs that can be administered by an ambulance paramedic.
A recently published report into methadone related deaths in Glasgow found that lives could have been saved if resuscitation protocols for non-paramedic ambulance crews had allowed them to administer naloxone.²
In a recent incident at the Glasgow drug problem service (GDPS), an unconscious patient was "dumped" by his "friends" at the administrative offices. There had been no doctor on site. However, a quick thinking accident and emergency trained GDPS nurse administered naloxone, probably saving the person's life.
This incident has been the catalyst for the formation of the Greater Glasgow primary care trust's Crown protocol committee. A group protocol for the administration of naloxone has been drawn up following the template in Appendix A of the Crown guidelines.³ This has now received the approval of the trust's drug and therapeutics committee. Training of the GDPS nurses is now under way and an audit trail will be introduced once that has been completed.
However, the problem as far as non-paramedically trained ambulance personnel and the general public remains. There were 85 drug-related deaths in Glasgow city during 1999, the majority of which were heroin related.
One has to ask how many lives could have been saved if naloxone had been more widely available and had been capable of administration by anyone in such an emergency?

Kay Roberts
Glasgow

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