Naloxone Myths

Naloxone puts opioid users into withdrawal—which is a very unpleasant experience—and takes away from the positive euphoria of opioid use. The following studies have accordingly concluded that the availability of naloxone does not encourage people to use more drugs or to use drugs in riskier ways

• Karen H. Seal et al., Naloxone Distribution and Cardiopulmonary Resuscitation Training for Injection Drug Users to Prevent Heroin Overdose Death: A Pilot Intervention Study, 82(2) Journal of Urban Health 303–311 (2005) (Participants trained in overdose prevention and use of naloxone increased their knowledge of heroin overdose management, while heroin use decreased).
• Temple University of the Commonwealth System of Higher Education, Beasley School of Law, Project on Harm Reduction in the Health Care System, Memorandum, Legal Analysis of Switching Naloxone from Prescription to Over the Counter, July 6, 2005 (Two European studies found no serious adverse effects and observed no increase in risky behavior associated with naloxone availability).
• Scott Burris et al., Legal Aspects of Providing Naloxone to Heroin Users in the United States, 12 The International Journal of Drug Policy 237-248 (2001) (One survey of heroin users found that few would use more following administration of naloxone).
• Sarz Maxwell et al., Prescribing Naloxone to Actively Injecting Heroin Users: A Program to Reduce Heroin Overdose Deaths, 25(3) Journal of Addictive Diseases 89- 96 (2006) (Participants in naloxone programs reported no interest in increasing dosage or injecting more frequently as a result of naloxone availability).
• Nancy Worthington et al., Research, Opiate Users’ Knowledge About Overdose Prevention and Naloxone In New York City: A Focus Group Study, 3(19) Harm Reduction Journal (2006) (Aversion to effects of naloxone administration in study participants refutes concerns of riskier drug-taking activity in opiate users).
• Karla D. Wagner et al., Evaluation of an Overdose Prevention and Response Training Program for Injection Drug Users in the Skid Row Area of Los Angeles, CA, 21(3) International Journal of Drug Policy 186-193 (2010) (Overdose prevention and response training programs may be associated with improved overdose response behavior).

In addition, there may be unanticipated benefits of naloxone distribution: a recent study found that witnesses to overdose who administered naloxone were less likely to share syringes than those who did not administer naloxone. This finding points to “the potential wider, positive effects or behavioral modifications that naloxone distribution may have beyond its ability to reduce overdose risk behaviors or reverse an overdose,” such as potentially helping to reduce
transmission of hepatitis C and HIV.

Research studies demonstrate that drug users can effectively recognize an overdose and respond correctly with naloxone:

Traci C. Green, Distinguishing Signs of Opioid Overdose and Indication for Naloxone: An Evaluation of Six Overdose Training and Naloxone Distribution Programs in the United States, 103 Addiction 979-989 (2008) (“[T]his study reports initial evidence of the effectiveness of overdose training and naloxone distribution programs in opioid overdose recognition and response. People trained through these programs identify opioid overdoses and indications for naloxone as well as medical experts and consistently scored higher in knowledge of overdose and naloxone indication scenarios than their untrained counterparts.”).

On the contrary, studies demonstrate that naloxone program participants may be more likely to access treatment:

• Karen H. Seal et al., Naloxone Distribution and Cardiopulmonary Resuscitation Training for Injection Drug Users to Prevent Heroin Overdose Death: A Pilot Intervention Study, 82(2) Journal of Urban Health 303–311 (2005) (Drug treatment entry increased after participation in naloxone distribution and overdose prevention and management program).

Naloxone is a resource that drug users want. By providing it, harm reduction programs can, at the very least, get access to drug users and build relationships with them. This may lead to other health benefits, like HIV testing and treatment, counseling, and drug treatment.