Providing naloxone in the emergency department can save lives

A survey finds that approximately half of the patients said that they were carrying naloxone after their ED visit and two-thirds planned to continue carrying naloxone in the future.

More than 800,000 Americans died from an overdose between 1999-2019, and the annual rate of overdoses has increased dramatically during the pandemic, according to the latest data from the Centers for Disease Control and Prevention.

A hand holding a syringe on a table with latex gloves and two naloxone kits.
Image: Governor Tom Wolf via Flickr

Roughly seven in 10 current overdose deaths involve opioids, which means that many of them could be prevented with naloxone. Naloxone, also known by its brand name Narcan, acts to reverse opioid overdoses and save lives when used in time. It is easy to carry and use, and studies have demonstrated that laypeople can administer it safely and effectively to reverse overdoses.

But many of the people who are most likely to witness an overdose, including individuals who use opioids and their friends and family members, may not have easy access to naloxone. Strategies are needed to increase uptake, carrying, and administration of naloxone, especially among at-risk individuals in the community who may not be engaged in routine health care or with community naloxone distribution efforts.

However, many at-risk individuals find themselves in the emergency departments (ED), either because of an overdose or other complications of substance use. The Perelman School of Medicine’s Anish Agarwal, an assistant professor of emergency medicine, and Margaret Lowenstein, an assistant professor of medicine, recently examined the potential for ED visits as a critical, reachable moment to engage high-risk individuals in overdose prevention. As reported in JAMA Network Open, the team reached out to at-risk patients prescribed naloxone in the ED to understand whether they had obtained their naloxone during or after their ED visit, whether they were carrying it, and their plans to carry it in the future.

The survey asked patients about their experiences and perceptions following the ED encounter related to accessing, using, and carrying naloxone. The responses indicate that most of the patients did not carry naloxone prior to their ED, but over a third reported having a personal history of an overdose requiring naloxone, and more than a quarter had used naloxone to reverse an overdose for another person in the past. Approximately half of the patients said that they were carrying naloxone after their ED visit, and two-thirds planned to continue carrying. And of patients not carrying naloxone prior to their ED visit, 54% reported a plan to continue carrying in the future.

This story is by Anish K. Agarwal and Margaret Lowenstein. Read more at Penn LDI.