Nav: Home

Take-home naloxone should be an additional standard of care for prevention of heroin overdose death

March 29, 2016

Death from opioid overdose is preventable through timely administration of the antidote naloxone. Several countries now provide take-home naloxone (THN) to opioid users for emergency use, but mostly as pilot schemes and without formal evaluation. A new study published today by the scientific journal Addiction found that take-home naloxone programs reduce overdose mortality and have a low rate of adverse events. The study recommends take-home naloxone as a new standard of care for prevention of heroin overdose deaths.

The study estimates that naloxone successfully reversed heroin overdose in 96 to 99% of cases. The study also found no empirical evidence that THN programs encourage heroin use.

The evaluation of THN programs is challenging: randomized controlled trials are often considered the gold standard of scientific study, but conducting trials for THN would often be unethical and fraught with difficulties given the infrequency and unpredictability of overdose.

To get around that problem, this study used the Bradford Hill criteria: a standard tool for assessing the impact of broad-based public health interventions where it is ethically not feasible or operationally impractical to conduct randomized controlled trials. The Bradford-Hill criteria were devised in 1965 by British epidemiologist and statistician Sir Austin Bradford Hill to assess causality when only correlational data are available.

The application of the Bradford Hill criteria to the current evidence base from non-randomized studies found that THN programs have improved survival rates among program participants and reduced heroin overdose mortality rates in the community, with a low rate of adverse events.

Co-author Professor John Strang, Head of the National Addiction Centre at King's College London, said: "This study is the first to assess the international evidence-base on take-home naloxone, and we found that the antidote successfully reversed overdose in the large majority of cases where the drug was administered.

"These findings strongly support the distribution of take-home naloxone to carers, drug users and their friends and families to prevent deaths from heroin overdose."

Professor Strang added: "The vast majority of studies included in this review reported on heroin overdoses, so future research will need to examine the impact of take-home naloxone for overdoses from long-acting opioids, such as methadone or prescription opioid medications."

The study, conducted by researchers at the National Addiction Centre at King's College London, used data from 22 observational studies of THN programs in the USA, Canada, UK and Germany. The number of participants in each study averaged 203, ranging from 24 to 2,912.
Interviews with lead author John Strang can contact him at the National Addiction Centre, King's College London by email ( or telephone (+44 020 7848 0438).

McDonald R and Strang J (2016) Are take-home naloxone programs effective? Systematic review utilizing application of the Bradford Hill criteria. Addiction, doi:10.1111/add.13326

This paper is free to download for one month after publication from the Wiley Online Library: or by contacting Jean O'Reilly, Editorial Manager, Addiction,, tel +44 (0)20 7848 0853.

About Journal

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, illicit drugs, tobacco, and gambling as well as editorials and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884. Addiction is the number one journal in the 2015 ISI Journal Citation Reports Ranking in the Substance Abuse Category (Social Science Edition).


Related Death Articles:

Death by volcano?
he discovery of anomalously high levels of mercury in rocks from the Ordivician geological period has led to a new interpretation of the ensuing mass extinction.
Starvation causes atypical cell death
Researchers from IDIBELL -- within the Marie Curie ITN TRAIN-ERs -- have characterized the cell death process due to starvation, in which the endoplasmic reticulum plays a leading role.
Does death of a sibling in childhood increase risk of death in surviving children?
Bereavement in childhood due to the death of a sibling was associated with an increased risk for death in both the short and long term, according to a new article published by JAMA Pediatrics.
A kiss of death to drug the 'undruggable'
Scientists at the University of Dundee have reported a major breakthrough in targeting the causes of many diseases, using a 'kiss of death' to destroy proteins which had previously been regarded as 'undruggable.'
Overall rate of death from cancer decreases in US
The overall rate of death from cancer declined about 20 percent between 1980 and 2014; however, there are distinct clusters of counties in the US with particularly high cancer mortality rates, according to a study in the Jan.
More Death News and Death Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Do animals grieve? Do they have language or consciousness? For a long time, scientists resisted the urge to look for human qualities in animals. This hour, TED speakers explore how that is changing. Guests include biological anthropologist Barbara King, dolphin researcher Denise Herzing, primatologist Frans de Waal, and ecologist Carl Safina.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...