Up and Down
Naloxone is a medication used to reverse opioid overdoses. It works by reversing the depression of the respiratory and central nervous systems caused by opioids [1]. Paramedics have carried naloxone for decades, and it is becoming an increasingly common item for police officers and firefighters to carry [2]. The drug is prescribed to patients on high doses of opioids as well as to nonmedical opioid users [3]. In 2015, the FDA approved a pocket-sized naloxone auto-injector, making the antidote even more accessible for use in a nonmedical environment [4]. As the prevalence of opioid addiction and overdoses continues to rise, questions about naloxone’s availability and distribution are made even more significant. Many wonder: Is naloxone enabling opioid addicts, and if so, do the harms outweigh the benefits?
Some argue that naloxone is a safe and effective treatment for opioid overdoses and has the potential to save countless lives. Supporters compare the drug to epinephrine and glucagon injections made available to anaphylactic and diabetic patients [5]. They argue that, as is the case with those treatments, naloxone should be readily available for treating those with an opioid use disorder. Pennsylvania’s Governor Tom Wolf, in support of making naloxone more widely available, said of opioid addiction, “This is a disease, not a moral failing” [6]. Furthermore, since the friends and family of opioid users are often in a better position to respond quickly to an overdose than emergency personnel, one might think the drug should be accessible to them as well.
Others argue that making naloxone readily available gives opioid users a false sense of security, encouraging them to test the limits of their highs and making them more likely to repeatedly overdose [7]. One opioid user has been revived by naloxone 70 times in a single year [8]. Maine’s Governor Paul LePage, opposing legislation that would increase access to naloxone, said “Naloxone does not truly save lives; it merely extends them until the next overdose… creating a situation where an addict has a heroin needle in one hand and a shot of naloxone in the other produces a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction” [9]. One might also worry that having naloxone so readily available may lead to its being administered when not necessary, causing acute opioid withdrawal and putting everyone in the situation at risk.
DISCUSSION QUESTIONS
Who should have access to naloxone? Emergency personnel? People with opioid prescriptions? Nonmedical opioid users? Should it be available over the counter?
Is there anything morally problematic about taking away a large part of the consequences of drug addiction?
When it comes to drug-related policies, which is more morally important: promoting the well-being of drug-users, or reducing the rates of drug use?
References
[1] Drugs.com, “Naloxone (Monograph)”
[2] North Carolina Harm Reduction Coalition, “US Law Enforcement Who Carry Naloxone”
[3] National Safety Council, “Prescription Nation: 2016 American Drug Epidemic”
[4] Food and Drug Administration, http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm391465.htm
[6] The New York Times, “Naloxone Saves Lives, but Is No Cure in Heroin Epidemic”
[7] WHCS Eyewitness News, “Former heroin addict speaks out about reviving overdose patients”
[8] Daily Beast, “Life Is Hell After Narcan, Heroin’s Miracle Cure”
[9] The New York Times, “Naloxone Saves Lives, but Is No Cure in Heroin Epidemic”
