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Home > Topics > Medical / Clinical
September 04, 2012
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EMS News in Focus
by Arthur Hsieh

Publicly available naloxone: Benefits outweigh the risks

No data currently exist to suggest that having antidote freely available will increase frequency of illicit narcotic use

By Arthur Hsieh

Editor's note: The FDA is considering making naloxone, or Narcan, an over-the-counter drug, while there is a bill pending in Congress to fund programs to train civilians how to use the controversial overdose antidote.

This article is getting some interesting comments by industry professionals. I've commented previously on public access to naloxone, the narcotic antagonist used for heroin and other narcotic-based overdoses.

Since the introduction of the intranasal route of administration, the opportunity for EMS personnel other than paramedics to administer it as well as the general public has made its use increasingly controversial.

This is how I see it:

1) Naloxone is a very safe medication. Given properly, the risk of adverse side effects is minimal. The intranasal route is relatively slow compared to intravenous injection, making for a more controlled uptake.

2) During the past 20 years, we have seen technological evolution bring previously "advanced" procedures to the masses. Public-access AEDs is one example. Epinephrine autoinjectors is another.

3) An AED is to a cardiac arrest what naloxone is to a narcotic overdose. Its effectiveness is time-based. The sooner it can be administered, the better the chances of reversing respiratory depression and preventing subsequent cardiac arrest. We are unable to be in all places at all times, so why not give the victim an opportunity to survive that mistake?

4) No data currently exist to suggest that having an antidote freely available will increase the frequency of illicit narcotic use.

It will be interesting to see where this will go. At least to me, the benefits outweigh the risk.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
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