Opioids are the main driver of lethal drug overdoses in the United States, according to the Centers for Disease Control and Prevention, which resulted in 46,802 deaths in 2018, usually due to a person having stopped breathing.
Naloxone – a drug approved by the Food and Drug Administration used to reverse overdoses of opioids, such as heroin, morphine, and oxycodone – works to restore normal breathing for a person whose breathing has slowed or stopped.
“Opioid overdoses cause the largest number of accidental and avoidable deaths,” said Peter Davidson, Ph.D., assistant professor in the department of medicine at the University of California San Diego School of Medicine. The human toll from drug addiction is devastating. Using naloxone to prevent opioid overdoses could save many lives and it has saved this. “
In a study published in the March 23, 2021 online edition of International Journal of Drug PolicyDavidson and an international group of researchers found that opioid users who participate in the 12-step abstinence program and recently stopped using the drugs refused to take naloxone at home, even if taking it on hand could save lives.
For the study, trained interlocutors visited regions with high drug use in three southern California counties: San Diego, Orange and Ventura. Forty-four participants were asked questions about initiation of drug use and overdose experiences, whether it was their own or observed treatments or previous treatments.
“In our research, individuals who have recently abstained from opioid use believe that carrying naloxone symbolically links them to the drug-use identity they were trying to leave behind,” said senior author Janet Bowles, Dr. Center for Medicines Policy Evaluation in Toronto, Canada, but was a postdoctoral fellow at the University of California San Diego School of Medicine at the time of the study.
The 12-step programs encourage abstinence through social behaviors that include distancing themselves from people, places and things considered related to drug use. Naloxone was seen as an ingredient associated with substance abuse, collision with these sober behaviors, and their goal of abstinence.
To reduce the stigma associated with naloxone, researchers suggest reframing what naloxone pregnancy means to represent a commitment to group safety and the well-being of those “still suffering” and renaming naloxone training programs in drug use disorder treatment settings as a “first aid overdose.”
Additionally, the researchers suggest focusing on the life-saving effect that those trained in administering naloxone can have on their peers, redirecting naloxone distribution efforts to include people at any stage of drug use, including abstinence.
“It’s very important for people to understand that after periods of abstinence, the body becomes less tolerant if an individual resumes drug use, which makes them physiologically more vulnerable to overdose and death,” said Davidson, co-author and lead investigator. “If someone experiences an opioid overdose, it is important to recognize the signs and respond quickly to prevent death.”
In the United States, laws now allow people to access and use naloxone to respond to an overdose with protection from liability.
The Addiction Recovery and Treatment Program at UCSD provides patients with outpatient behavioral therapy for substance abuse, such as marijuana, alcohol, and opioids.
The co-authors are: LR Smith, ML Mittal, E. Copulsky and G. Hennessy, all from the University of California, San Diego. RW Harding and KD Wagner, University of Nevada, Reno; And A. Dunkle, Solace Foundation.