A call for compassionate opioid overdose response.

Autor: Russell E; Health Management Associates, 2501 Woodlake Cir Suite 100, Okemos, MI 48864, USA. Electronic address: erussell@healthmanagement.com., Hawk M; University of Pittsburgh School of Public Health, Behavioral and Community Health Sciences, 130 DeSoto Street 6127 Public Health, Pittsburgh, PA 15261, USA. Electronic address: meh96@pitt.edu., Neale J; King's College London, 4 Windsor Walk IoPPN, Denmark Hill, London SE5 8AB, United Kingdom. Electronic address: joanne.neale@kcl.ac.uk., Bennett AS; New York University, School of Global Public Health, 708 Broadway, NY, NY 10003, USA. Electronic address: asb19@nyu.edu., Davis C; Network for Public Health Law, 7101 York Ave S. #270, Edina, MN 55435, USA. Electronic address: cdavis@networkforphl.org., Hill LG; The University of Texas at Austin, 2409 University Ave, A1910, PHR 2.222, Austin, TX 78712, USA. Electronic address: lucas.hill@austin.utexas.edu., Winograd R; University of Missouri, St. Louis, 43 Benton Ct, St. Louis, MO 63121, USA. Electronic address: rachel.winograd@umsl.edu., Kestner L; Center for Prevention Services' Queen City Harm Reduction, 811 Eastway Dr., Charlotte, NC 28205, USA. Electronic address: kestner@preventionservices.org., Lieberman A; Network for Public Health Law, 7101 York Ave S. #270, Edina, MN 55435, USA. Electronic address: alieberman@networkforphl.org., Bell A; Prevention Point Pittsburgh, 460 Melwood Ave, Suite 100, Pittsburgh, PA 15213, USA. Electronic address: abell@pppgh.org., Santamour T; Florida Harm Reduction Collective, 4601 3rd Ave N., Saint Petersburg, FL 33713, USA. Electronic address: director@flhrc.org., Murray S; Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center, 801 Massachusetts Ave, Boston, MA 02119, USA. Electronic address: stephen.murray@bmc.org., Schneider KE; Johns Hopkins Bloomberg School of Public Health, 1812 Ashland Ave, Office 333, Baltimore, MD 21030, USA. Electronic address: kschne18@jhu.edu., Walley AY; Grayken Center for Addiction, Clinical Addiction Research and Education Unit, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, 801 Massachusetts Ave, Boston, MA, 02119, USA. Electronic address: alexander.walley@bmc.org., Jones TS; T. Stephen Jones Public Health Consulting, 123 Black Birch Trail, Florence MA 01062, USA. Electronic address: t.stephen.jones@gmail.com.
Jazyk: angličtina
Zdroj: The International journal on drug policy [Int J Drug Policy] 2024 Nov; Vol. 133, pp. 104587. Date of Electronic Publication: 2024 Sep 18.
DOI: 10.1016/j.drugpo.2024.104587
Abstrakt: High dose and long-acting opioid overdose reversal drugs can precipitate withdrawal in people who are opioid dependent. Products recently brought to market for community use in the United States (US) have drawn international concern because of their increased risk of withdrawal. At the March 18-19, 2024, Compassionate Overdose Response Summit & Naloxone Dosing Meeting, a panel of harm reduction experts issued the following call to action: 1) people who use drugs should be directly involved in decisions regarding the research, development, selection, and distribution of opioid overdose reversal products; 2) regulatory agencies and pharmaceutical manufacturers should carefully consider and communicate the risk and duration of withdrawal associated with higher dose and longer-acting opioid antagonists; 3) take-home naloxone kits should include at least two doses of an intramuscular (IM) product containing 0.4 mg or an intranasal (IN) product containing ≤4 mg; 4) At this time, high dose and long-acting opioid antagonists have no use in acute opioid overdose response; and, 5) overdose response educational materials, instructions on overdose response, and training should emphasize the restoration of breathing, avoiding withdrawal, and compassionate post-overdose support and care. High dose and long-acting opioid overdose reversal drugs were approved without testing for withdrawal and are often aggressively marketed despite decades of evidence from naloxone distribution programs worldwide that the ideal dose of naloxone is one that restores breathing without inducing withdrawal. Government agencies should direct resources to harm reduction programs to make standard dose take-home naloxone products widely available among people who use drugs. Lay bystanders, people who use drugs, their families, and professional first responders can learn and apply a compassionate approach to opioid overdose response.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: 1. Erin Russell discloses that Harm Reduction Therapeutics is a client of Health Management Associates. HRT is a nonprofit organization based in the United States that manufactures a 3 mg naloxone nasal spray product. 2. In the last three years, Joanne Neale has secured, through her university, research funding from Mundipharma Research Ltd (for research on naloxone) and Camurus AB (for research on long-acting injectable buprenorphine). She has also received honoraria from Indivior and Camurus AB for presentations and from Figure 8 Consultancy Ltd for research advice on a study of residential rehabilitation.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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