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Naloxone use: unintended consequences and recommended community response

Summary and Analysis…

This study looks into the effects when Naloxone is introduced into efforts to combat opioid overdose. While Naloxone is a life-saving drug when an individual overdoses and the authors do not recommend suspending its use, they do find that: “broadening Naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality. ”

The authors suggest that because of this, the public health community needs to understand and properly prepare when instituting Naloxone use:

“…our results suggest that Naloxone’s effects may depend on the availability of local drug treatment: when treatment is available to people who need help overcoming their addiction, broad Naloxone access results in more beneficial effects. Increasing access to drug treatment, then, might be a necessary complement to Naloxone access in curbing the opioid overdose epidemic.”

Note that the full paper is available from the link below.

Excerpted from SSRN.com

The United States is experiencing an epidemic of opioid abuse. In response, many states have increased access to Naloxone, a drug that can save lives when administered during an overdose. However, Naloxone access may unintentionally increase opioid abuse through two channels: (1) saving the lives of active drug users, who survive to continue abusing opioids, and (2) reducing the risk of death per use, thereby making riskier opioid use more appealing. By increasing the number of opioid abusers who need to fund their drug purchases, Naloxone access laws may also increase theft. We exploit the staggered timing of Naloxone access laws to estimate the total effects of these laws. We find that broadening Naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality. These effects are driven by urban areas and vary by region. We find the most detrimental effects in the Midwest, including a 14% increase in opioid-related mortality in that region. We also find suggestive evidence that broadening Naloxone access increased the use of fentanyl, a particularly potent opioid. While Naloxone has great potential as a harm-reduction strategy, our analysis is consistent with the hypothesis that broadening access to Naloxone encourages riskier behaviors with respect to opioid abuse.

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