依存症研究と治療ジャーナル

抽象的な

Feasibility and Acceptability of Over-The-Counter Distribution of Take-Home Naloxone: A Systematic Review

Mustapha Karikari, Emma Sename Baxey

Introduction: Opioid drugs or narcotic analgesics, are the most prescribed analgesics for effective pain management. Additional desirable effects of opioids lead to its high abuse risk. The most fatal outcome of overdose is death resulting from respiratory depression, hypoxia, brain damage and coma. Naloxone, a fast-acting opioid antagonist is proven to be effective for the reversal of opioid overdose effects, however with limited access. Over-thecounter distribution of take-home naloxone in community pharmacies is a medium of distribution that can increase accessibility to individuals at risk of opioid overdose deaths.

Methods: PubMed, Embase, Web of Science, PsycINFO and the Cochrane library were searched for peer reviewed literature using the main terms; opioids, opioid abuse, opioid overdose deaths, naloxone, take-home naloxone and over-the-counter distribution. Grey literature and other specialists’ websites were also searched. Seven papers met the inclusion criteria for this systematic review.

Results: Selected study results were synthesized qualitatively, and the results of this study indicates that overthe- counter distribution of take-home naloxone is acceptable and feasible in increasing the accessibility of takehome naloxone for the prevention of opioid overdose fatalities.

Conclusion: Over-the-counter distribution of take-home naloxone is an acceptable and feasible novel intervention that can increase the accessibility of this medicine to individuals at risk of opioid overdose deaths. Implementation challenges identified with over-the-counter distribution of take-home naloxone such as cost, lack of appropriately packaged naloxone products for over-the-counter distribution, elaborate licensing and certification procedures for pharmacist and legislations that affect the stocking and dispensing of naloxone, needs to be collaboratively tackled by all stakeholders to achieve successful outcomes of this intervention.