Title: Recommendations

Context:
Naloxone administration has been identified as a life saving measure following opioid overdose. A  systematic review of 22 observational studies provided moderate quality evidence that take home  naloxone programs are effective in improving overdose survival and decreasing mortality, with a low rate  of adverse events.[108] One meta-analysis of nine studies determined that take home naloxone kits were  used approximately nine times within the first three months of follow-up for every 100 individuals  trained.[109] Further, studies have shown that naloxone administration has been efficacious whether  given by medical personnel or lay people, with more than 26,000 reversals documented by the CDC from  1996-2014.[110,111] In addition, prescription of naloxone rescue and accompanying education has also  been found to reduce opioid-related emergency department visits.[112] Distribution of naloxone for  reversal is supported by SAMHSA, the American Medical Association (AMA), and other medical societies,  and is facilitated through the VA via Pharmacy Benefits Management. Clinical efficacy has been established  for its use on short-acting opioids, but not for its use on long-acting opioids such as methadone or  exceptionally potent opioids.[108]

Question: Is there any evidence that take-home naloxone programs are effective in improving overdose survival and decreasing mortality, with a low rate of adverse events?

Answer: A  systematic review of 22 observational studies provided moderate quality evidence