Naloxone Is Cheapest Way to Stop Heroin Overdoses, S.F. Researchers Say
A new study released this week says that the antidote naloxone is definitely the most cost-effective way to prevent people from dying after they overdose on drugs, which is now the leading cause of injury and death for opioid users (heroin), accounting for about 80 percent of those deaths.
Naloxone, which comes in the form as a nasal spray, is a "safe and effective antidote" that works by temporarily blocking opioid receptors, according to the study, conducted by San Francisco researchers with the Department of Public Health.
As of 2010, 183 public health programs around the country, including those supported by the San Francisco Department of Public Health, trained some 53,000 individuals in how to use naloxone, and these programs documented more than 10,000 cases of "successful overdose reversals."
The Department of Public Health spends $73,000 a year for the Oakland-based Drug Overdose and Prevention Education Project (DOPE Project) to buy, distribute, and train people in the use of naloxone. As of November 2011, the city had saved 600 lives since it started doling out naloxone in 2003.
Per the DPH:
The authors of this study developed a mathematical model to estimate the impact of distributing naloxone in this way. Their model was based on conservative estimates of the number of overdoses that occur each year. It accounted for people who overdose repeatedly, and it acknowledged that most people who overdose will survive whether or not they get naloxone. In their basic model, [researchers] estimated that reaching 20 percent of a million heroin users with naloxone would prevent about 9,000 overdose deaths over their lifetime. One life would be saved for every 164 naloxone kits given out. Based on optimistic assumptions, naloxone could prevent as many as 43,000 deaths -- one life for every 36 kits given out.
Distributing naloxone would cost roughly $400 for every "quality-adjusted year of life gained," according to the study. This value is well below the customary $50,000 cutoff for medical interventions.
"Naloxone is a highly cost-effective way to prevent overdose deaths," said Phillip Coffin, director of Substance Use Research at the Department of Public Health and Assistant Clinical Professor at UCSF. "And as a researcher at the Department of Public Health, my priority is maximizing our resources to help improve the health of the community."
Naloxone distribution has existed in San Francisco since the late 1990s, with SFDPH support since 2004. During that time, heroin overdose fatalities slowly decreased from 155 in 1995 to just 10 in 2010.
Opioid analgesic deaths, including oxycodone, methadone, and hydrocodone, numbered 121 in 2010. The DPH is trying to expand access to naloxone for patients receiving prescription opioids as well.