Take-home naloxone to treat opioid overdose in the community
Take-home naloxone should be discussed with all people at increased risk of opioid-related overdose and those close to them (as they are likely to be the people administering the drug). This can include patients prescribed opioids for management of chronic pain (especially those taking high doses of opioids or concurrently taking other drugs with sedative effects such as benzodiazepines or gabapentinoids). Patients with a disorder of opioid use are at increased risk of overdose, including those using buprenorphine or methadone for medication-assisted treatment of opioid dependence. For patients with palliative care needs, consider the potential benefits and harms of prescribing take-home naloxone, and the patient's prognosis, goals of care, and preferences.
Take-home naloxone is available as a nasal spray1 or preprepared injection. It can be obtained free of charge and without prescription through the Take Home Naloxone program in all Australian states and territories. It is also available on prescription, subsidised through the Pharmaceutical Benefits Scheme (PBS).
Educate the patient's family or peers to give naloxone in the event of an overdose; patient information sheets are available from the New South Wales Health website for the nasal spray and the preprepared injection. The Pharmacy Programs Administrator Online website includes practical pointers on planning for naloxone use, such as recording where naloxone is kept and ensuring all household members know the location.