Opioid Treatment Programs Should Provide Naloxone to Patients

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I have an idea for how to lower drug overdose deaths. Clearly the culprit here is that people feel safe using too many drugs because if they overdose and someone calls 911, the paramedics will save them. So let's dismantle EMS or at least forbid them to respond to drug overdose calls. After all, EMS is a safety net and without it, people will stop using drugs. Plus taxpayers won't have to pay paramedics to respond to people who should know better.

Obviously, I'm kidding. But this is the same logic that many opioid treatment program (OTP) administrators apply when arguing against the distribution of naloxone to patients. It sends the wrong message. It will be used as a backup plan. It encourages relapse. The fact is that most people in recovery do relapse and many OTP patients continue to use other drugs while in treatment. Additionally, OTP patients have friends and family who continue to use drugs and are likely to need naloxone as well.

"I have witnessed dozens of patients over the years of my involvement with an Opioid Treatment Program (OTP) who have experienced the trauma of losing a family member or friend due to an accidental overdose or the scare of a near overdose," says Jonas Coatsworth, President of the South Carolina Association for the Treatment of Opioid Dependence (SCATOD). "The availability of naloxone for distribution in OTPs would be an asset in reducing the instances of these unfortunate events in our local communities. The distribution of naloxone would enhance the components of care already existing within OTPs in offering the proper response to the various issues related with opioid use disorder through prevention and treatment. In our communities, we are more than capable to raise awareness, provide the proper education, and should have the ability to offer a potential 'lifesaver'."

So what keeps more OTPs from offering naloxone to patients? It's not cost (naloxone is being offered for free in many states with community distribution programs). It's not breaking new ground (naloxone has been available to people in recovery for over 18 years and used by paramedics for over 50). It's not safety (naloxone is one of the safest medications on the market). There is a need. There is a solution. We should use it.

To be fair, many OTPs currently offer naloxone kits and overdose prevention training to their patients, including 26 in North Carolina. Over the past two years, support for overdose training and naloxone has made astonishing strides, not only in the treatment community, but among law enforcement, EMS, recovery organizations and medical providers. Community-based efforts have resulted in over 10,000 reversals with naloxone by lay people.

If an OTP patient doesn't want naloxone, no one will force them to take it. But if they do need it, bureaucracy or out-dated moral policy should not stand in the way. Naloxone is a safe, cost-effective tool to save lives that is proven not to cause people to use more drugs. There is no excuse not to offer it if we truly care about recovery and human life.