Expanded Access to Opioid Overdose Intervention: Research, Practice, and Policy Needs
Authors: Wilson M. Compton, Nora D. Volkow, Douglas C. Throckmorton, Peter Lurie
Journal: Annals of Internal Medicine (2013)

Editorials1 January 2013Expanded Access to Opioid Overdose Intervention: Research, Practice, and Policy NeedsWilson M. Compton, MD, MPE, Nora D. Volkow, MD, Douglas C. Throckmorton, MD, and Peter Lurie, MD, MPHWilson M. Compton, MD, MPEFrom National Institute on Drug Abuse, Bethesda, Maryland, and U.S. Food and Drug Administration, Silver Spring, Maryland., Nora D. Volkow, MDFrom National Institute on Drug Abuse, Bethesda, Maryland, and U.S. Food and Drug Administration, Silver Spring, Maryland., Douglas C. Throckmorton, MDFrom National Institute on Drug Abuse, Bethesda, Maryland, and U.S. Food and Drug Administration, Silver Spring, Maryland., and Peter Lurie, MD, MPHFrom National Institute on Drug Abuse, Bethesda, Maryland, and U.S. Food and Drug Administration, Silver Spring, Maryland.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-1-201301010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Rates of fatal drug overdoses have more than doubled in the United States over the past decade to become one of the leading causes of preventable injury death. Overall drug overdose deaths increased to a record of 38 329 in 2010, outpacing deaths from motor vehicle traffic crashes nationally for 2 years running (1). Most of the increase in such deaths is related to prescription opioids and mirrors an increase in opioid prescribing (1, 2). Diversion of these medications contributes to the problem (3), and both higher opioid doses and polysubstance use are significant contributing factors (3, 4).Many actions are ...References1. Centers for Disease Control and Prevention. Prescription Drug Abuse and Overdose: Public Health Perspective. Atlanta, GA: Centers for Disease Control and Prevention; 2012. Accessed at www.cdc.gov/primarycare/materials/opoidabuse/index.html on 9 November 2012. Google Scholar2. Centers for Disease Control and Prevention (CDC). Vital signs: overdoses of prescription opioid pain relievers—-United States, 1999–2008. MMWR Morb Mortal Wkly Rep. 2011;60:1487-92. [PMID: 22048730] MedlineGoogle Scholar3. Hall AJ, Logan JE, Toblin RL, Kaplan JA, Kraner JC, Bixler D, et al. Patterns of abuse among unintentional pharmaceutical overdose fatalities. JAMA. 2008;300:2613-20. [PMID: 19066381] CrossrefMedlineGoogle Scholar4. Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152:85-92. [PMID: 20083827] LinkGoogle Scholar5. Office of National Drug Control Policy. Epidemic: Responding to America's Prescription Drug Abuse Crisis. Washington, DC: Office of National Drug Control Policy; 2011. Accessed at www.whitehouse.gov/sites/default/files/ondcp/issues-content/prescription-drugs/rx_abuse_plan.pdf on 5 November 2012. Google Scholar6. Szalavitz M. Preventing overdose: Obama administration drug czar calls for wider access to overdose antidote. Time Health & Family. 22 August 2012. Accessed at http://healthland.time.com/2012/08/22/preventing-overdose-obama-administration-drug-czar-calls-for-wider-access-to-overdose-antidote on 5 November 2012. Google Scholar7. Centers for Disease Control and Prevention (CDC). Community-based opioid overdose prevention programs providing naloxone—United States, 2010. MMWR Morb Mortal Wkly Rep. 2012;61:101-5. [PMID: 22337174] MedlineGoogle Scholar8. Coffin PO, Sullivan SD. Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. Ann Intern Med. 2013;158:1-9. LinkGoogle Scholar9. Boyer EW. Management of opioid analgesic overdose. N Engl J Med. 2012;367:146-55. [PMID: 22784117] CrossrefMedlineGoogle Scholar10. Doe-Simkins M, Walley AY, Epstein A, Moyer P. Saved by the nose: bystander-administered intranasal naloxone hydrochloride for opioid overdose. Am J Public Health. 2009;99:788-91. [PMID: 19363214] CrossrefMedlineGoogle Scholar11. U.S. Food and Drug Administration. Role of Naloxone in Opioid Overdose Fatality Prevention: Public Workshop. Silver Spring, MD: U.S. Food and Drug Administration; 2012. Accessed at www.fda.gov/Drugs/NewsEvents/ucm277119.htm on 5 November 2012. Google Scholar12. Throckmorton DC, Compton WM, Lurie P. Management of opioid analgesic overdose [Letter]. N Engl J Med. 2012;367:1371. [PMID: 23034041] MedlineGoogle Scholar13. Gugelmann HM, Perrone J. Can prescription drug monitoring programs help limit opioid abuse? JAMA. 2011;306:2258-9. [PMID: 22110107] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From National Institute on Drug Abuse, Bethesda, Maryland, and U.S. Food and Drug Administration, Silver Spring, Maryland.Disclaimer: The views and opinions expressed in this commentary are those of the authors and should not be construed to represent the views of the National Institute on Drug Abuse, the National Institutes of Health, the U.S. Food and Drug Administration, or the U.S. government.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-2814.Corresponding Author: Wilson M. Compton, MD, MPE, National Institute on Drug Abuse, 6001 Executive Boulevard, MSC 9589, Bethesda, MD 20892-9589; e-mail, [email protected].Current Author Addresses: Dr. Compton: National Institute on Drug Abuse, 6001 Executive Boulevard, MSC 9589, Bethesda, MD 20892-9589.Dr. Throckmorton: U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Building 51, Room 6132, Silver Spring, MD 20993.Dr. Lurie: U.S. Food and Drug Administration, Office of the Commissioner, 10903 New Hampshire Avenue, Building 1, Room 2320, Silver Spring, MD 20993.Dr. Volkow: National Institute on Drug Abuse, 6001 Executive Boulevard, Bethesda, MD 20892. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Distributing Naloxone to Heroin Users for Lay Overdose Reversal Phillip O. Coffin and Sean D. Sullivan Metrics Cited ByPredictors of US states’ adoption of naloxone access laws, 2001–2017The North American Opioid EpidemicHospital Care for Opioid use in Illinois, 2016–2019Association of Take-Home Naloxone and Opioid Overdose Reversals Performed by Patients in an Opioid Treatment ProgramFindings from the recovery initiation and management after overdose (RIMO) pilot study experimentReasons People Who Use Opioids Do Not Accept or Carry No-Cost Naloxone: Qualitative Interview StudyDrivers of the fatal drug epidemicSubstance Use Policy Interventions: Intended and Unintended ConsequencesThe Opioid Epidemic and the Role of Law Enforcement Officers in Saving LivesLessons learned in methods and analyses for pragmatic studiesThe U.S. opioid epidemic: One disease, diverging talesFrom Peers to Lay Bystanders: Findings from a Decade of Naloxone Distribution in Pittsburgh, PAPharmacokinetic properties of intranasal and injectable formulations of naloxone for community use: a systematic reviewPrescribing naloxone for opioid overdose interventionUse of naloxone nasal spray 4 mg in the community setting: a survey of use by community organizationsOpioid recovery initiation: Pilot test of a peer outreach and modified Recovery Management Checkup intervention for out-of-treatment opioid usersInternational patent applications for non-injectable naloxone for opioid overdose reversal: Exploratory search and retrieve analysis of the PatentScope databaseThe Opioid Epidemic: Crisis and SolutionsTake-home naloxone treatment for opioid emergencies: a comparison of routes of administration and associated delivery systemsTwenty years of take-home naloxone for the prevention of overdose deaths from heroin and other opioids—Conception and maturationWearable Devices and Biosensing: Future FrontiersGoing “social” to access experimental and potentially life-saving treatment: an assessment of the policy and online patient advocacy environment for expanded accessPharmacokinetic Properties and Human Use Characteristics of an FDA-Approved Intranasal Naloxone Product for the Treatment of Opioid OverdoseCombating Opioid Overdose With Public Access to NaloxoneDevelopment of Maryland Local Overdose Fatality Review TeamsNaloxone Administration in US Emergency Departments, 2000–2011Relationship between Nonmedical Prescription-Opioid Use and Heroin UsePatient perspectives on an opioid overdose education and naloxone distribution program in the U.S. Department of Veterans AffairsDistribution of naloxone for overdose prevention to chronic pain patientsWorking together: Expanding the availability of naloxone for peer administration to prevent opioid overdose deaths in the Australian Capital Territory and beyondAssociations between childhood trauma and non-fatal overdose among people who inject drugsOverdose rescues by trained and untrained participants and change in opioid use among substance-using participants in overdose education and naloxone distribution programs: a retrospective cohort studyDevelopment and Implementation of an Opioid Overdose Prevention Program Within a Preexisting Substance Use Disorders Treatment CenterCommentary on Williams et al . (2014): Family matters-new resources for managing opioid overdose with take-home naloxoneRedressing the epidemics of opioid overdose and HIV among people who inject drugs in Central Asia: The need for a syndemic approach 1 January 2013Volume 158, Issue 1Page: 65-66KeywordsAddictionDrug abuseDrug policyOpioidsPrevention, policy, and public healthPsychiatry and mental healthSubstance abuseTherapeutic drug monitoring ePublished: 1 January 2013 Issue Published: 1 January 2013 PDF DownloadLoading ...