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Better access to an overdose-reversing medication could save lives

Blog post | 28 Nov 2019

A nasal spray that can temporarily reverse the effects of an opioid overdose in an emergency has been added to the Pharmaceutical Benefits Scheme (PBS).

Until recently, opioid overdoses were typically treated with an injection of the medication naloxone.

At-risk people can now get a nasal spray form of naloxone, Nyxoid, from pharmacies and other health services. Because it’s subsidised by the Government on the PBS, a prescription costs from $6.50 (for concession card holders).

How does naloxone work?

Naloxone temporarily stops opioid drugs, such as oxycodone, fentanyl, codeine and heroin, from attaching to opioid receptors in the brain during an overdose. By blocking the opioid receptors, it reverses the dangerously slow and ineffective breathing, known as ‘respiratory depression’, that leads to death in opioid overdose.

Ready-to-use naloxone can be administered by medical professionals or paramedics, as well as by family, friends or other first responders in an emergency situation. Research shows that most people can be trained in 5-15 minutes to be able to identify an overdose, intervene and administer naloxone.

Who is this medicine for?

Naloxone may be prescribed for people at risk of opioid overdose, including those taking prescription opioids for chronic pain, people who use illicit opioid drugs (and substitutes such as methadone) and people accessing detox and rehab services.

As part of a Take Home Naloxone pilot program, certain individuals will also be offered naloxone (now including the nasal spray Nyxoid) for free and without a prescription. The initiative will operate from various health services in New South Wales, South Australia and Western Australia.

The Take Home Naloxone pilot will run from 1 December 2019  to 28 February 2021, with a possible national roll-out to follow. See ‘For more information’, below.

Why has Nyxoid been added to the PBS?

Nyxoid nasal spray is now on the PBS because the spray is easier for many people to administer than a naloxone injection.

The scale of the problem is a second reason: Every day in Australia, 3 people die from drug-induced deaths involving opioid use. Many more are admitted to hospital or suffer from opioid dependence.

Opioid-induced deaths account for more than half of all drug-induced deaths, and most of those deaths are caused by pharmaceutical opioids (rather than illicit opioids such as heroin).

  • In 2016-17, 15.4 million opioid prescriptions were dispensed under the PBS to more than 3 million Australians.
  • In 2016-17, there were 5,112 emergency department visits and 9,636 hospitalisations due to opioid poisoning.

Australian Institute of Health and Welfare

Opioid poisoning and overdose are serious problems in Australia. But, since most deaths from overdose occur in the presence of another person, easy access to ready-to-use naloxone in the form of a nasal spray may save more lives.

Are there downsides to naloxone?

All medicines can have side effects. An opioid-dependent person who is given a high dose of naloxone may experience symptoms associated with opioid withdrawal such as nausea, vomiting, sweating, trembling, nervousness and a fast pulse.

For a full list of possible side-effects for anyone using Nyxoid, check the Consumer Medicines Information (CMI) for Nyxoid here.

People who have been treated with naloxone may experience a strong urge to take more opioid drugs, particularly if they are dependent.

For more information

  • Talk to your doctor or pharmacist.

  • Contact the Pharmacy Programs Administrator to find out how to register for the Take Home Naloxone pilot on 1800 951 285 (9am to 8pm AEST, Monday to Friday).

  • For advice on medicines, including naloxone, call the NPS Medicines Line on 1300 MEDICINE (1300 633 424; 9am to 5pm AEST, Monday to Friday).

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