Opioids are commonly used to manage pain but are also used recreationally, and sometimes children accidentally gain access to and ingest them. When opioids are misused or unintentionally ingested — even if they have been prescribed — there is a risk of overdose. Respiratory depression, a main hazard of severe opioid overdose, is potentially fatal.
Naloxone is a non-selective, short-acting opioid receptor antagonist. Opioid receptor antagonists are medications typically used to reverse respiratory depression caused by opioid overdose.
Dispensing naloxone to opioid users so they can self-treat in the event of an opioid overdose, rather than rely on a health professional to administer treatment, may be an effective way to reduce overdose-related deaths. In Canada, there are at least four cities with local overdose prevention and response programs involving naloxone dispensing, and British Columbia has recently launched a provincial program.
A review of the clinical and cost-effectiveness of the administration of naloxone by non-health care professionals in a home or community setting compared with its administration by health professionals, as well as of the evidence-based guidelines for administering naloxone, will help inform decisions on how to prevent opioid overdose-related deaths.
A limited literature search was conducted of key resources, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria (population, intervention, comparator, outcomes, and study designs).
The literature search identified 227 citations, with 2 additional articles identified from other sources. Of these, 13 were deemed potentially relevant; however, none met the criteria for inclusion in this review.
- When comparing naloxone administration by non-health professionals in a home or community setting with naloxone administration by health professionals:
- no clinical effectiveness information was found
- no cost-effectiveness information was found.
- No guidelines on the administration of naloxone were found.
- Evidence on take-home naloxone programs suggests that they are associated with a low mortality rate, but it is not known how this rate compares with the mortality rate when naloxone is administered by health care professionals.