The Pharmaceutical Journal
Vol 277 No 7420 p382
30 September 2006

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Proposal put forward for naloxone to be available over the counter

Making naloxone available over the counter in pharmacies is one of the proposals put forward in a BMJ editorial published last week (2006;333:614).

Needle exchange programmes and voluntary agencies are also cited as places where naloxone could be made available in order to reach drug users who are not in treatment programmes.

John Strang, director of the National Addiction Centre, and colleagues write that timely injection of the opiate antagonist naloxone rapidly reverses the respiratory suppression of heroin overdose, a major cause of death in young people. They argue that three proposals should be considered to increase the availability of naloxone, which is primarily prescribed and administered by doctors or ambulance crews.

First, further training could be provided in emergency administration by non-health care staff in police stations, rehabilitation hostels, prisons and remote communities. Secondly, patients or carers could administer naloxone to those who have taken an overdose and, thirdly, naloxone could be available over the counter at pharmacies, needle exchange programmes and voluntary agencies. They acknowledge that although this would increase access it would require further legislation and members of the public would need training.

Mr Strang has offered advice to one of two pilot projects that are about to start in Scotland (PJ, 17 June 2006, p708). A scheme in Lanarkshire which will make naloxone available to high-risk drug users and their families and friends is due to get under way within the next two weeks. The project will use a patient group direction to enable nurses to administer and supply naloxone. They will also be trained to teach drug users, and a friend or relative, how to administer the drug. The pilot phase does not include pharmacists but extending the scheme to community pharmacies is something that will be considered once the pilot has been evaluated, a spokesman for Lanarkshire Alcohol and Drug Action Team told The Journal.

Three pharmacists from Glasgow Addiction Services will be involved in a similar pilot, which is due to start in November. If the trial is deemed to be a success then there are plans to roll it out to providers across Glasgow, including community pharmacies.