The U.S. is facing an unprecedented number of opioid-related overdose deaths, and an array of other countries have experienced increases in opioid-related fatalities. In the U.S., naloxone is increasingly distributed to first responders to improve early administration to overdose victims, but its cost-effectiveness has not been studied. Lay distribution, in contrast, has been found to be cost-effective, but rising naloxone prices and increased mortality due to synthetic opioids may reduce cost-effectiveness. We evaluate the cost-effectiveness of increased naloxone distribution to (a) people likely to witness or experience overdose (“laypeople”); (b) police and firefighters; (c) emergency medical services (EMS) personnel; and (d) combinations of these groups.

A generation of people born in the 1960s and 1970s, known as Generation X, are dying from suicide or drug poisoning in greater numbers than ever. ONS data for England and Wales has shown that in the late 1980s to early 1990s, the age at which most people died by taking their own lives or drug poisoning was concentrated around this generation, when they were in their 20s.

Naloxone is a well-established essential medicine for the treatment of life-threatening heroin/opioid overdose in emergency medicine. Over two decades, the concept of ‘take-home naloxone’ has evolved, comprising pre-provision of an emergency supply to laypersons likely to witness an opioid overdose (e.g. peers and family members of people who use opioids as well as non-medical personnel), with the recommendation to administer the naloxone to the overdose victim as interim care while awaiting an ambulance.

Community members responding to an overdose with naloxone are more likely to seek emergency help when naloxone does not work or takes more time to work. Published in Drug and Alcohol Dependence, the results show several factors associated with calling emergency services when helping someone with naloxone.

St. Paul’s Early Discharge Rule was derived to determine which patients could be safely discharged from the emergency department after a 1‐hour observation period following naloxone administration for opiate overdose. The rule suggested that patients could be safely discharged if they could mobilize as usual and had a normal oxygen saturation, respiratory rate, temperature, heart rate, and Glasgow Coma Scale score.

Release surveyed each of the 152 local authority areas in England, as local authorities are responsible for commissioning drug services, which give out take-home naloxone. The report includes findings on the availability of take-home naloxone across local authority areas, the scale of take-home naloxone supply in community settings, and coverage among people who use opiates and opiate clients in drug treatment.