Question  What is the projected burden of the opioid epidemic in fatal overdoses, and interventions such as prescribing reductions, naloxone distribution, and treatment expansion associated with mitigation of the epidemic? Findings  In this decision analytical model of the US population aged 12 years or older, under status quo, an estimated 484 429 individuals were projected to die of fatal opioid overdose over 10 years. A combination of reducing opioid prescribing, increasing naloxone distribution, and expanding treatment for opioid use disorder was associated with an estimated 179 151 lives saved when compared with the status quo.

The mechanical, chemical, and structural properties of the nanofibrous hydrogel enable subcutaneous administration and slow, diffusion-based release kinetics of naloxone over 30 days in vitro. The naloxone hydrogel scaffold showed cytocompatibility and did not alter the β-sheet secondary structure or thixotropic properties characteristic of self-assembling peptide hydrogels. Our results show that this biocompatible and injectable self-assembling peptide hydrogel may be useful as a vehicle for tunable, sustained release of therapeutic naloxone. This therapy may be particularly suited for preventing renarcotization in patients who refuse additional medical assistance following an overdose.

Until recently, the overdose crisis has been at the forefront of public health efforts in the United States (US). However, with the COVID-19 pandemic and rapid rise in cases across the country, attention has quickly shifted at the federal and state levels from overdose response to minimizing the spread of COVID-19. Rapid public health approaches have been implemented across jurisdictions, including widespread business closures, transitions to telemedicine, temporary closures of parks, and social distancing orders. While necessary to flatten the epidemiological curve of the pandemic, these public health approaches have largely failed to account for the unintended consequences such policies have on structurally vulnerable populations, including people who use drugs (PWUD).

Case Study of Harm Reduction, Homelessness and Drug Use in Dublin, Ireland

Dublin has outperformed even best-case scenarios for COVID-19 mortality among homeless and drug using populations… the importance of strategic clarity and delivery, housing, lowered thresholds to methadone provision, Benzodiazepine (BZD) provision and Naloxone availability were key determinants of policy success. Further, given the rapid collapse in policy barriers to these interventions that COVID-19 produced, it is important to secure and protect these improved policy responses into the post-COVID19 era.

Abstract: Opioid overdose deaths are a major health issue in Australia and around the world. Programmes to provide opioid consumers with ‘take-home’ naloxone to reverse overdose exist internationally, but uptake by mainstream health services and consumers remains inconsistent. Researchers have identified a range of important educational, training and logistical impediments to take-home naloxone uptake and distribution, yet they have focused less on the social dynamics that can enhance or limit access, such as stigma.

Opioid overdose is a major public health issue associated with substantial morbidity and mortality in Australia. Indeed, nearly half the IDRS sample in 2019 reported having experienced an opioid overdose. Naloxone is an important intervention which reverses opioid overdose and has been available over-the-counter in Australia since 2016. This bulletin describes the awareness of naloxone and the take-home naloxone program in Australia, both nationally and by jurisdiction. It also explores access, use and acceptance of naloxone, and examines demographic differences for these aspects.