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Dramatic Expansion of Naloxone Programs amid Rising Drug Overdose Rates

Community programs report over 26,000 uses of naloxone by laypeople
At least 644 naloxone programs across 30 states & D.C.

Community-based overdose prevention programs providing naloxone have expanded dramatically since 2010, according to a new report published by the Centers for Disease Control and Prevention (CDC).

Naloxone programs map from MMWR


The report, co-authored by Eliza Wheeler of the Harm Reduction Coalition, found that by June 2014, at least 644 local, community-based opioid overdose prevention programs in the United States provide naloxone to laypeople, including drug users, their friends and family, and service providers who may witness an overdose.

Since the first program began in 1996, the 644 local take-home naloxone programs reported 26,463 drug overdose reversals using naloxone, after having trained and provided naloxone to 152,283 people. There are currently take-home naloxone programs located in 30 US states and the District of Columbia.

“Thousands of fatal overdoses occur every year – but this report shows that we can reduce overdose deaths by giving drug users and their families access to naloxone,” said Eliza Wheeler, one of the report authors and program manager at the Harm Reduction Coalition, which runs model overdose prevention programs in New York City and San Francisco. “We need to recognize that take-home naloxone programs are highly effective, fund them accordingly, and support the life-saving work that they do.”

Drug overdose deaths in the United States have more than doubled since 1999. During 2013, 43,982 drug overdose deaths, and among these, 16,235 were associated with prescription opioids, and 8,257 with heroin. Naloxone is the standard of care for treatment of potentially fatal respiratory depression caused by opioid overdose. In response to rising overdose rates among heroin users in the late 1990s, community-based programs began prescribing naloxone and training people who use opioids how to respond to an overdose.


“The rapid growth of these programs is critical to nationwide overdose prevention efforts, and we hope that access to life-saving medications is supported by the pharmaceutical manufacturers, governmental authorities, and community members whose participation is key for their ongoing success,” said Michael Gilbert, co-author of the report.

“Opioid overdoes is a medical emergency. Getting naloxone in the hands of people who are on the scene of an overdose increases the chance that the person who has overdosed will survive,” added co-author Dr. T. Stephen Jones.

The new report, Opioid Overdose Prevention Programs Providing Naloxone to Laypersons—United States 2014, was published today in CDC’s Morbidity and Mortality Weekly Report. The data provide an update to a similar report from 2012, the first to publish results from the community-based naloxone programs in the United States. The previous report provided data from the 188 programs that existed as of 2010, in only 16 states. This report shows that naloxone programs have expanded rapidly since 2010, including an increase in the number of laypersons provided naloxone kits (from 53,032 to 152,283) and an increase in the number of reversals reported (from 10,171 to 26,463).

The distribution of naloxone began at syringe exchanges, and now, other programs including substance use treatment facilities, Veterans Administration health care systems, primary care clinics, and pharmacies have started providing naloxone to laypersons. This report highlights the fact that the majority of people who perform overdose reversals using naloxone received from overdose prevention programs are people who use drugs.

According to this report, there are 20 states that have no opioid overdose prevention programs that distribute naloxone. The authors hope that by highlighting the successes of the existing programs, more attention and resources can be allocated to this life-saving intervention. The report concludes that public health agencies should, as part of a comprehensive prevention program, implement community-based opioid drug overdose prevention programs including training and providing naloxone to potential overdose witnesses and assess the impact of these programs.

Co-author Dr. Peter Davidson noted, “This study shows that naloxone can be delivered to drug users and those close to them in a wide variety of settings, and that doing so has led to tens of thousands of successful overdose reversals and lives saved.”

Harm Reduction Coalition has responded to the prescription opioid and heroin overdose crisis by advocating for broader access to naloxone, supporting state legislation, providing technical assistance and policy support, and implementing model programs. Harm Reduction Coalition supports removal of legal, financial and regulatory barriers to naloxone access for laypersons as part of a comprehensive strategy to end the prescription opioid and heroin overdose epidemic.

To search for the program nearest you, please the overdose prevention program locator.

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