Take-home cure saves drug users

Drug users successfully administered the antidote Lives have been saved by giving drug users an antidote to treat others who overdose, a study has shown.

Trials were so successful that the measure has been introduced at the Maudsley Hospital in London.

The professor leading the work estimated it could prevent half of all deaths from heroin overdose.

The drug naloxone is used to resuscitate people who have overdosed on opiates such as heroin.

In trials in Berlin and Jersey, which provided the first evidence of the initiative's success, users were given supplies of the drug and trained to administer it.

It works by blocking the opiate receptor cells so they prevent the opiate in the blood stream from taking effect.

Recipients, even when seconds away from death, respond to treatment immediately.

Reduction in deaths

Professor John Strang, director of the National Addiction Centre had the idea to give users the drug instead of it being given by doctors.

He told BBC News Online: "When then idea occurred to me, it was like a light was switched on in my head."

He said if the measure could reduce overdose deaths by anything like half, it would be worthwhile.

"If this could prevent anything like that, it would be a radically powerful intervention."

Under the Maudsley's initiative, naloxone will be offered to all patients seen by their drug treatment service who have been through their in-patient detox plan, who are starting methadone treatment or who have just come out of prison.

The drug has been used by doctors for around 40 years, and costs between £3.30 and £6.70 for a ready-prepared syringe.

People who receive it still need to be cared for in hospital.

Users who are provided with it will also be taught resuscitation skills.

Eventually family members living with a drug user could also be trained to use naloxone.

The success of the treatment depends on overdoses happening in a situation where the drug can be given, in a domestic setting, and not when a user is alone.

Research by the National Addiction Centre found three quarters of overdoses occur when the person is with others, and in a domestic setting.

Around 2% of heroin addicts overdose each year.

Study

In the Berlin trial, carried out in January 1999, 124 drug users took part in the project.

Of the 40 who reported back, 22 had given emergency naloxone to 29 recipients, who all recovered.

Its use was judged appropriate in 90% of cases. It was of "uncertain benefit" in two cases, and in one - where the victim had overdosed on cocaine, it was pointless, but not harmful.

It was given at home in 59% of cases, and in parks or public toilets in 38%.

In 10 cases, the recipient was unknown to the person resuscitating them.

The drug can be injected into the muscle, into the vein, or under the skin.

In 34% of cases, the patient suffered opiate withdrawal symptoms.

In the Jersey study, carried out in 1998, 101 drug users were provided with the drug.

Five resuscitations were reported, and all fully recovered.

A spokesman for Drugscope, an advisory group for drug users welcomed the idea as "another weapon in the armoury to tackle drug addiction", which he said would help reduce the number of drug related deaths.

George Hunter, project director of Turning Point Scotland's Glasgow Drugs Crisis said he was considering introducing the idea, and said the city saw 100 opiate deaths every year.

"At the moment when people do see someone overdosing, people tend to panic and run away.

"It's rare that they ring for an ambulance because that involves the police. At best, they ring for the ambulance and then run away."

The study is published in the BMJ.

-- Anonymous, April 15, 2001