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Naloxone

Naloxone Project: Background

Naloxone is an antidote used to reverse the effects of opioid drugs like heroin, morphine and methadone if someone overdoses.

The HSE is currently undertaking a demonstration project to assess and evaluate the suitability and impact of using a prefilled Naloxone injection which is designed for non-medical administration in Ireland. The overall objective of the project is to make naloxone more widely available for opioid drug users.

The project involves 600 opiate users receiving take-home naloxone on prescription. It will also include those recently released from custody who have been identified as at high risk of opioid overdose. These drug users and those close to them have been trained on how to administer naloxone, which comes in a pre-filled syringe, and to recognise the signs of an overdose.

Evaluation report

Download the External Evaluation of the Naloxone Demonstration Project Report

The HSE Naloxone Demonstration Project Update: Video Interview with Denis O’Driscoll, Project Lead HSE Naloxone Demonstration Project August 2016:

Overdose information

Visit our overdose page for information on overdose and overdose prevention.

Naloxone & Overdose Frontline Workers Pack

Conditions of use

  1. I understand that this manual is to be used by workers and trainers who have received the appropriate training by recognised trainers.
  2. This manual can not be amended without consultation and permission from the National Quality Assurance Group.
  3. This resource remains the Copyright of the HSE and must be noted if used in relation to other reasons outside of the Naloxone programme.

I have read, understood, and agree to be bound by the conditions of use. By downloading and using the policies, I indicate that I have read, understood and agree to be bound by the conditions of use. 

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Naloxone Demonstration Project: Training Videos

Below are a series of short training videos for the Naloxone Demonstration Model. Click the play button to play each video online. Other versions, including mobile phone versions, can be downloaded by clicking the links below each video.

 

Video 1: Signs and symptoms of an opioid overdose

Video 1 Downloads: Mobile SD (480x270); SD (640x360); HD 720p (1280x720);

 

Video 2: Conducting Cardiopulmonary resuscitation (CPR)

Video 2 Downloads: Mobile SD (480x270); SD (640x360); HD 720p (1280x720)

 

Video 3: Saving a life

Video 3 Downloads: Mobile SD (480x270); SD (640x360 ); HD 720p (1280x720)

 

Video 4: Administering Naloxone

Video 4: Mobile SD (480x270); SD (640x360); HD 720p (1280x720)

 

Naloxone Demonstration Project: FAQ's

Q1. Is the Demonstration Project for 600 kits or 600 individuals?
A. Initially 600 individuals will be included into the demonstration project

Q2. If someone either uses their kit / looses the kit or leaves it in a hostel  - will it be replaced?
A. If lost or left behind the prescriber will need to prescribe another product for that individual and notify centrally i.e. the Naloxone Demo Project what happened to the product and record same per the proposed evaluation and recording format.

Q3. Can the Naloxone be safely administered to a pregnant female
A. Pregnancy: The safety of this medicinal product for use in human pregnancy has not been established. Evaluation of embryo or foetus, the course of gestation and peri- and postnatal development. Prenoxad Injection should, like all drugs, be used with caution during pregnancy.

In a pregnant woman who is known or suspected to be opioid-dependent, risk benefit must be considered before Prenoxad Injection is administered, since maternal dependence may be accompanied by foetal dependence. In this type of circumstance, the neonate should be monitored for respiratory rate and signs of opioid withdrawal.

Use in Labour and Delivery: Naloxone Injection may be administered to mothers during the second stage of labour to correct respiratory depression caused by opioids used to provide obstetrical analgesia. It is not known if Naloxone affects the duration of labour and/or delivery.

Lactation: It is not known whether Naloxone is excreted in human milk. Because many drugs are excreted in human milk caution should be exercised when Prenoxad Injection is administered to a nursing mother.

Links:
http://bit.ly/1FMEUeD

http://bit.ly/1ENAUs9

The following search function on MHRA is also useful:
http://www.mhra.gov.uk/spc-pil/index.htm

Q4. Are pregnant females at higher risk of overdose?
A. There is little evidence to suggest this but from March 2011 The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom.  It reported that out of 35 known substance misusers who died 10 were attributed to overdose. Furthermore theoretically, the physical compression of the lungs in late pregnancy could mean that there is less respiratory reserve, should respiratory depression occur.

http://bit.ly/1JnPUOs

Furthermore If the woman is on an ineffective dose during pregnancy (due to active dose reduction or reduced serum methadone concentrations due to pharmacokinetic changes as pregnancy progresses) then there would be a theoretical risk of relapse of heroin use and overdose risk.

Q5. If Naloxone has been administered and the individual refuses to go into an Ambulance and decides they want to re use later, how long should they wait until using again?
A. It is advised that from the training that all persons take the advice of attending the hospital as Naloxone has a short half life and there is a risk of a relapse into overdose.  The harm reduction advice is to ensure that the patient is aware of the signs of overdose and the risks associated with consuming again.

Q6. Where will the Kits be held and can all GP's prescribe Naloxone?
A. All GPs can prescribe Naloxone see hpra.ie for those authorised in Ireland. The kits, Prenoxad will be made available to sites directly to the prescribers once the required training has been completed from the project lead Denis O’Driscoll denis.odriscoll@hse.ie as although this product is authorised in Ireland it is not currently refundable and therefore there will be a charge.

Q7. What will the Gardai do?
A. If your friend becomes ill after taking drugs call an ambulance and PLEASE STAY WITH THEM – emergency services, including Gardai, are interested in saving lives NOT reporting or prosecuting you or your friends for using drugs in these situations – Please think and always act responsibly”

 

Naloxone launch exhibition photography

Photo's taken by Tim Bingham

 

 

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