I thoroughly enjoyed your recent articles on substance abuse in the June 13 issue of CMAJ, especially Kyle Stevens' essay.1 I cannot help but think that if the narcotic antagonist naloxone was made readily available to heroin addicts and others as a harm reduction measure (perhaps as an expansion of a needle exchange program) there would be fewer deaths from opiate overdose. After all, most addicts would have little trouble subcutaneously or intravenously injecting naloxone into an unresponsive friend while awaiting a 911 response,2 and the drug would certainly not be used for recreational purposes. Indeed, this idea is being seriously explored in the addiction literature.3,4
Signature
D. John Doyle
Department of Anesthesia Toronto General Hospital Toronto, Ont
References
- 1.Stevens KD. Stemming needless deaths: "medicalizing" the problem of injection drug use [commentary]. CMAJ 2000;162(12):1688-9. [PMC free article] [PubMed]
- 2.Wanger K, Brough L, Macmillan I, Goulding J, MacPhail I, Christenson JM. Intravenous vs subcutaneous naloxone for out-of-hospital management of presumed opioid overdose. Acad Emerg Med 1998;5:293-9. [DOI] [PubMed]
- 3.Darke S, Hall W. The distribution of naloxone to heroin users. Addiction 1997;92:1195-9. [PubMed]
- 4.Strang J, Powis B, Best D, Vingoe L, Griffiths P, Taylor C, et al. Preventing opiate overdose fatalities with take-home naloxone: pre-launch study of possible impact and acceptability. Addiction 1999;94:199-204. [DOI] [PubMed]