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Lynn Ruane The overdose drug Naloxone can save lives so let's remove the barriers to accessing it

There are more deaths in Ireland as a result of overdose than road traffic accidents and many of these deaths are preventable, writes senator Lynn Ruane.

IN 2003, I was hired to develop an initiative for teenagers who were using heroin.

One particular week we were learning about how to respond to an overdose.

The young people had witnessed a number of overdoses but the methods they were using to respond were scary. 

Given their exposure to overdose, it was an essential part of my job to help them learn better ways to keep themselves and their friends safe.

We talked through the basics, such as recognising an overdose and how to put people into the recovery position.

However, at the time this was pretty much the limit of it – knowing the recovery position and staying with the person overdosing until an ambulance arrived.

Thankfully, a lot has changed since then and now we have access to Naloxone.

Naloxone is an opioid antagonist. In simple terms, it temporarily reverses the effects of heroin, so it can save the user from an overdose death. 

In a country where we have a very high rate of overdose-related harm and deaths, in which opioids are often implicated, the importance of this medicine can’t be overstated.

Almost half the people who die from an overdose in Ireland were not alone when they died, so someone could have administered Naloxone and saved their lives if it were available and the companion was trained.

Naloxone is safe, recommended by the World Health Organisation and saves lives around the world. Naloxone comes in both intranasal (up the nose) and injectable forms.

However, there’s a problem. Currently, Naloxone has to be prescribed by a doctor to a patient and isn’t available over the counter to people even to people who are specially trained to administer it.

In my view, this needs to change. 

I recently spoke to Dr Patrick O’Donnell from Limerick about a case there. He explained that one evening an experienced staff member from the Ana Liffey Drug Project, who was trained in harm reduction, came across a person who had overdosed on heroin in a public place.

The staff member actually offers training to others on how to manage an overdose and to use Naloxone. The problem is that she didn’t have any Naloxone with her. 

The law as it currently stands means that staff members in facilities that help addicts, cannot have Naloxone prescribed to them as they are not personally at risk of overdose.

The person experiencing the overdose did not appear to have any Naloxone on them either, and nor is it safe or appropriate to be going through someone’s pockets looking for medication they might be prescribed.

This meant that the staff member had to ring an ambulance, put the person in the recovery position and wait for a period of time for help to arrive. This was a waste of precious time and could potentially have cost the person overdosing, their life.

We need to remember:

There are more deaths in Ireland as a result of overdoses than road traffic accidents. 

While the HSE has been training people as part of the Naloxone programme in Ireland, the lack of availability of the drug itself, however, is undermining these efforts. 

The training needs to be rolled out across all addiction service and homeless service providers and Naloxone should be available to staff in these projects and to outreach workers. 

Currently, only the person at risk of overdose (the patient) can be prescribed Naloxone. While they can have more than one product prescribed and do sometimes leave one with a friend or family member, we need to extend this access. 

As someone who has intervened in many overdoses, it makes much more sense to me for project workers, community drug workers, the Gardai, partners and family members to be able to access Naloxone themselves. After all, they are the ones who will have to administer it as they will usually be the first responders to an overdose.

The current legislation would need to be changed to make Naloxone more available and many organisations working in social care would also favour this approach. 

Another barrier to accessing Naloxone is the cost as not all GPs are registered with the programme and if your doctor is not registered with the programme then you will have to pay for the drug. 

This reduces the chances of an individual carrying Naloxone on their person as affordability in many cases will be a barrier to access.

It is crucial that GPs around the country participate in the Naloxone programme to avoid this.

Lynn Ruane is an independent senator. 

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