Cheap, Easy, and Lifesaving—Naloxone Treatment for Overdose

How much does it cost to save a life? That question got a clear and striking answer this week in the case of overdose from heroin in the United States. A study published in the Annals of Internal Medicine found that distribution of the overdose antidote naloxone—a safe, non-abusable, and inexpensive medicine—to one in five heroin users in the United States could prevent as many as 43,000 deaths. The cost of distribution would be equivalent to some of the cheapest, most effective, and most accepted medical interventions, like checking blood pressure at a doctor’s office.

The study used mathematical modeling to assess whether giving out naloxone was “worth it”—that is, to determine how much naloxone distribution would cost per “quality-adjusted” year of life gained. This is the measure used by economists and policymakers to compare health interventions and decide which ones are affordable. The naloxone study also investigated assumptions that patient advocates would rather not acknowledge—like whether it would be cheaper to let illegal drug users die, or to put them in jail. Those are ugly questions, but ones that certainly run through the minds of opponents of health services for drug users worldwide. The answer was that naloxone saves lives with costs far below what health or prison systems pay. For example, screening for cancer with colonoscopy costs over $50,000 per quality adjusted life year gained in the United States, and screening for HIV costs around $40,000.

Naloxone distribution saves lives for as little as $400.

The other question, of course, is whose lives are deemed worth saving. Drug overdose now kills more adults a year in the United States than motor vehicle accidents, or deaths from choking or accidental falls. Most of us have seen safety messages related to driving, choking, or minding our step, but naloxone and other measures to prevent overdose remain unknown to many at risk. As noted in an editorial in the same journal, co-authored by officials from the National Institute on Drug Abuse and the FDA, making new and easy-to-use formulations of the medicine can help. However, action can be taken now to make the medicine available to heroin users—actions that will prevent thousands of needless deaths, and spare family and friends who may have to watch helplessly as their loved ones stop breathing.

4 Comments

After having had a period a number of years ago when Naloxone was distributed to drug users in Jersey , CI, UK, this was suddenly discontinued without any reasonable explanation. We would love to have access returned to us. We meet resistance . Please keep up the good work in the hope that Drug Services come to their senses.

If indeed the drug Naloxone has been proven to be effective as you claim in your article, then it should be made available to those who need it- to curb the high incidence of deaths from drug abuse, etc.

Heroin overdoses should be treated the same as extreme allergic reactions with epinephrine. Naloxone (Narcan) and Nalorphine (Nalline) are antagonists with proven record. Now the overdoses- there is either very pure or very potent heroin in US- in Europe there were cases where anthrax was mixed in as a dilutant. (Some people might even have allergic reaction to milk poweders-brown sugars-food colorings). Heroin users are being treated with Naltrexone pills,injection,implants.(http://www.refindyourway.com/lang/en/Cat/6/id/228/Naltrexone-Implants.html. If there are poison hotlines- there are also hotlines for drug abuse/addiction , methadone clinics- etc. which should have Naloxone antagonist on hand to deal with opioid overdoses.

It is hard to find any logical justification for continuing the route we as a society are on, other than the economic one; that is to say, far too many people are making a lot of money coddling the status quo.
I was told recently that there is no 'Business Case ' for the way our cooperative operates. We function as a constructively engaged group of scrap collectors and processors with a dividend structure better than almost all of the 'Fortune 500' gang, but we have no Marketing staff, so there is no Business Case.

Best Regards

Martin G. Smith Ph.D

Chief Squid - Sw'Equity One - ABOTA LOCKSS
Research Coordinator - MATH Not METH - Camp One
Initiative Coordinator - Selkirk Light-Train

Collaborative Initiatives of RedSeven Services/ABOTA*

http://ca.linkedin.com/in/redsevenone

*[A Bridge Over The Abyss]

". . . The problems cover a range of issues, the solutions equally expansive and expensive, but unless these are dealt with head-on and now, future generations may well be unable to contend with our unwillingness to face up to reality" ---- Larry Campbell

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