Opiods overdoses : how to remedy this scourge ?

Opiods overdoses : how to remedy this        scourge ?

Fast facts

With the covid 19, the country saw a surge in the non-medical use of opiods. In 2020, about 9.5 millions americans were misusing opioids and in 2021 it was not less than 81 411 deaths  due to opiods overdoses that has been recorded. But past year marked a turning point in treatment of overdoses with 181 806 non-fatal cases and a 8 minutes average for emergencies to reach someone who is doing an overdose. Yet, opioids overdose remain the leading cause of accidental deaths in the USA.

Prevention

There are variety of ways to help reduce exposures to opiods and prevent opioid use disorder such as : state prescription drug laws to limit the access to opioids, improve awareness and share resources about the risks of prescription opioids, and the cost of overdose on patients and families, academic detailing to educate providers about opioid prescribing guidelines and facilitating conversations with patients about the risks and benefits of pain treatment options…

Another mean which is being set up is a dashboard to obtain and monitor data on non-fatal overdoses. It could allow to identify areas most at risk as well as the direct ressources and support ready to respond before it is too late. On top of that, a non-fatal overdose is the most important predictor of future fatal overdose, and it could permit to identify who survives an overdose.

Treatment

Naloxone. This is how is called the medication which could save dozens of thousands of lives per year. This medication, first approved in USA for opioids overdoses in 1971 is used to reverse depression of central nervous system and respiratory system caused by opiods. It start to be effective between 2 and 5 min after the injection which is essential when we know that you can die from an overdose within minutes. It block opiods effects for 30 to 60 minutes, therefore multiple doses can be required, but Massachusetts shared that 93.5 % of the people treated survived the overdose. In april 2021, the Food and Drugs Administration (FDA) approved a nasal spray of 8mg naloxone to treat opioids overdoses. This spray could last up to 90 minutes and is designed to be used by people without medical training. Besides, there are no know harmfull effects if it is injected to someone without opioids in their system. On march 29, it has been approved by the FDA to be sold over-the-counter. This spray will now be available without prescription, in vending machines, grocery stores, gas stations and even online. It will reduce the stigma associated with drug, since there will be no direct interaction with a pharmacist, and it is a powerfull message that noxolone is a critical public health tool for everyone. Emergent, the spray maker is aiming for a price of less than $50 for the pack of two 4mg doses, and the white house encouraged schools, restaurants, banks, businesses… to purchase it : « think about it as a smoke alarm or a defibrilator »

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