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GPs’ naloxone reminder amid rising opioid overdoses
GPs must have ‘non-judgemental, matter-of-fact conversations’ about the life-saving medicine, says a harm-reduction advocate.
Australia’s latest drug trends report reveals 27% of people have used naloxone to resuscitate someone who had overdosed in the past year.
A recent spate of ‘bad batch’ street drugs has been blamed for overdoses across Australia, with people impacted in New South Wales, Victoria and other states, of whom many had mistakenly taken opioids thinking they were other drugs such as stimulants.
Sydney GP, harm-reduction advocate and Chair of RACGP Specific Interests Addiction Medicine, Dr Hester Wilson, is sounding the alarm and encouraging GPs to speak with their patients about carrying naloxone – a medicine that can quickly reverse or reduce the effects of opioids.
‘What we need to be saying to people is be prepared: if you’re planning to take drugs, make sure you have naloxone,’ Dr Wilson told newsGP.
‘And it doesn’t need to be someone who is going to use the drugs, it could be someone they know, a community member who has friends or family they know might need naloxone.
‘Those are the conversations we need to be having, “If you are using drugs, we don’t want you to come to harm, so make sure you’ve got naloxone”.
‘For us as GPs, it’s not up to us to judge whether people should use drugs or not, that’s not our role. Our role is about health and wellbeing, and safety and harm.
‘We have these longitudinal relationships with individuals and families in our communities … we can encourage them to be aware, to have naloxone, to have those conversations.’
In recognition of the role of opioids in overdose deaths, from 1 July 2022 free naloxone became available nationally without the need for a prescription.
Dr Wilson’s reminder to raise awareness of life-saving naloxone come as the latest findings from the National Illicit Drug Reporting System, released this month, reveal that knowledge of and access to take-home naloxone over the past year remained stable in 2024, with 73% of people knowing it is available, and 46% accessing it.
For those who were aware of the life-saving medicine, 27% reported ever using it to resuscitate someone who had overdosed, with 17% having done so in the past year.
Synthetically produced opioids nitazenes, which are more potent than fentanyl and are emerging across Australia, are among the drugs contributing to increased overdoses and deaths.
Nitazenes were developed by scientists around 60 years ago as an alternative to morphine, but because of their high potential for overdose, were never released.
However, the drugs are accessible online and are being sold as other drugs, prompting health experts to again call for expansion of harm-reduction strategies such as pill testing and medically supervised injecting rooms.
The 2024 National Illicit Drug Reporting System found 11% of people reported that they or someone else had tested the content and/or purity of their illicit drugs in Australia in the past year.
Dr Wilson says there are constantly new nitazenes developed, and around 100 different varieties, as well as fentanyl and some illicit benzodiazepines.
‘So between all of them, it’s a really important message to get out: you don’t know what you’re buying, so have naloxone on hand, know what an opioid overdose looks like, give the dose and call an ambulance,’ she said.
‘Don’t be worried about calling an ambulance – you’re not going to get into trouble, you just want to make sure the ambulance will come and get that person to care.’
But, targeted education about take-home naloxone is not just for people who take illicit drugs, according to Dr Wilson.
‘For us as GPs, there’s two groups of people who use opioids, and we’d include in that those people for whom we’re prescribing opioids,’ she said.
‘It’s a high-risk medicine, and we know that more than 70% of overdoses are accidental. It might be that [for example] somebody’s on their opiates, they have extra pain so they take a bit extra, then they decide to have a drink, or they take some other sedating medications if they have a chest infection, and suddenly they’re overdosing.
‘We should be having these conversations with all our patients … if somebody’s on a high-risk medication we need to talk to them about this, because we don’t want them to come to harm.’
For the ‘much broader group’ of people who might use recreational drugs occasionally, Dr Wilson warns what they take could contain something that is opiate based, like the highly potent nitazenes or fentanyl, so GPs can help raise awareness.
‘They’re our neighbours, our families, the people we care about, our patients. And we just need to have this non-judgemental, matter-of-fact conversation with everybody,’ she said.
‘Naloxone is something just to have, and don’t lock it away in a cupboard, have it nearby as an emergency management. Consider it for people on opioids, but also for people who are using other drugs – these tragic recent deaths where they thought they were taking stimulants.’
A recent evaluation of the initial take-home naloxone pilot found it had saved up to an estimated three lives each day.
Available in two formats – the Nyxoid nasal spray and the Prenoxad injectable – naloxone can be accessed via:
- participating pharmacies – the Australian Government website details which pharmacists are taking part in the free take-home program
- over the counter from non-participating pharmacies for a fee
- needle syringe programs
- postage programs – available in some jurisdictions.
While participating pharmacies offer naloxone for free, people may need to ask the pharmacy to order it in, which can take 1–2 days, but it can be accessed anonymously.
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