Annals of Internal Medicine

Summaries for Patients
Naloxone for Heroin Overdose Reversal
What is the problem and what is known about it so far? In the United States, drug overdose is a leading cause of death. In some areas, public health departments are providing heroin users with naloxone, a drug that counters the effects of heroin, to use when they have overdosed on heroin or are with someone who has overdosed. Naloxone can often reverse the negative effects of heroin on breathing and other body functions, thereby preventing death and disability. Why did the researchers do this particular study? To find out how much it would cost per year of life gained to provide naloxone kits to heroin users and witnesses to heroin overdoses. Who was studied? The researchers did not study real patients. Instead, they developed a computer simulation that estimated what would happen if heroin users and those around them had naloxone in their possession and administered it during a heroin overdose. How was the study done? The researchers based the computer model on estimates from previous studies to determine how many overdose deaths might be prevented by distributing naloxone to heroin users and people likely to witness a heroin overdose. They also looked at the cost of providing naloxone in this way to calculate how much providing naloxone would cost per year of life gained. What were the limitations of the study? Computer simulations cannot definitively show what would happen in the real world. The model did not consider other positive aspects of naloxone distribution programs, such as reduced drug use resulting from peer education. What are the implications of the study? Distributing naloxone to heroin users to reverse overdose would be well within the range that U.S. society is typically willing to pay for health treatments.

The full report is titled “Cost-Effectiveness of Distributing Naloxone to Heroin Users for Lay Overdose Reversal.” It is in the 1 January 2013 issue of Annals of Internal Medicine (volume 158, pages 1-9). The authors are P.O. Coffin and S.D. Sullivan.

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