STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based

OVERDOSE PREVENTION AND NALOXONE PRESCRIPTION PROGRAMMES

What are their bases?

In many places, heroin use is responsible for most deaths from acute reactions to drug use or overdose. This is why the distribution of naloxone (an opioid antagonist) was suggested years ago as part of a broader strategy to prevent overdoses from heroin use. Naloxone blocks heroin's ability to occupy opioid receptors, rapidly reversing the acute effects of heroin overdose, mainly respiratory depression and sedation, which can lead to brain damage and death.

Practical implications

The use of naloxone in the framework of strategies to prevent overdoses is suited to two possible complementary strategies:

• Provide naloxone to emergency health services along with basic information on its use, allowing health workers to administer it when responding to an emergency heroin overdose.
• Distribute naloxone ampoules to drug users along with information on how to use it. Given that overdoses often happen at the user’s home and/or in the company of other people, the availability of naloxone could prevent many deaths, especially as many addicts are reluctant to notify the health services of an emergency. 

Naloxone distribution to drug users is often accompanied by basic training to improve recognition and identification of a heroin overdose, emergency manoeuvres to be carried out in these situations and the need to immediately contact an emergency medical service.