There seem to be a growing number of cases of high amounts of fluid in the lungs – known as noncardiogenic pulmonary edema – following administration of the opioid overdose antidote naloxone, experts said at a recent meeting of the New York Society of Addiction Medicine annual meeting. “The cause of naloxone-associated pulmonary edema is unclear. It may be that it is part of the natural history of opioid overdose, and we are just seeing it more often because we have the ability to save patients using an antidote. It could also be because when we wake people with naloxone, they try to take a deep breath against a closed airway, causing barotraumas – injuries caused by increased air or water pressure,” says Nicholas Nacca, MD, Assistant Professor of Emergency Medicine and Medical Toxicologist at the University of Rochester Medical Center. There is no hard data to support that this phenomenon...

The percentage of people treated for a drug overdose who need more than one dose of the opioid overdose antidote naloxone is on the rise, a new study suggests. Researchers from the Centers for Disease Control and Prevention (CDC) analyzed data from the National Emergency Medical Services Information System, and found the percentage of patients receiving multiple naloxone doses among emergency medical service (EMS) responders increased from 14.5 percent in 2012 to 18.2 percent in 2015, which represents a 26 percent increase in four years. “We found there were 31,000 cases in which two or more naloxone doses were needed in 2015 in a prehospital setting,” said lead author Mark Faul, PhD, Senior Health Scientist at the CDC. “Of those, 4,000 cases required three doses, 1,600 required four doses, 615 required five doses and 200 cases required six or more doses.” He noted that not all people requiring multiple naloxone doses...

The number of people that police in St. Louis have been able to save using the heroin overdose antidote naloxone, or Narcan, has declined by approximately 30 percent this year, compared to last year, according to the Associated Press. The St. Louis County Medical Examiner’s Office reported that nearly 90 percent of 121 overdose deaths through July of this year involved the drug fentanyl. Sometimes mixed with or sold as heroin, fentanyl is a powerful opiate that is considered stronger than heroin, making reversing an overdose from fentanyl more difficult. “The toxicity level of fentanyl is so potent, it might not be reversible,” said Spring Schmidt, director of health promotion and public health research for St. Louis County. “The potential for death is faster, and that impacts our ability to reverse an overdose.” Health officials noted that fentanyl overdoses may require more than one dose of Narcan to successfully revive patients....

A new study finds 10 percent of people saved by the opioid overdose antidote naloxone die within a year of treatment. “Patients who survive opioid overdoses are by no means ‘out of the woods,'” lead study author Scott Weiner, MD, Director of the Brigham Comprehensive Opioid Response and Education Program at Brigham and Women’s Hospital, said in a news release. “These patients continue to be at high-risk for overdose and should be connected with additional resources such as counseling, treatment and buprenorphine.” The study, presented at the annual meeting of the American College of Emergency Physicians, found half of patients who died within a year of naloxone treatment died within one month of treatment, HealthDay reports.

The price of naloxone is increasing at a time when the need for the opioid overdose antidote is growing, CNBC reports. Public officials say the price of naloxone is limiting how much they can purchase, which is potentially costing lives of people who are overdosing on heroin, fentanyl and prescription painkillers. “Why should we be priced out of a lifesaving medication at a time of public health emergency when we need it the most?” said Baltimore City Health Commissioner Dr. Leana Wen. “It’s unethical and inhumane to deny our patients and our cities lifesaving medications, and watch hundreds of thousands of citizens in our cities die.” She says her department has seen the cost of purchasing naloxone double in the last three years.

Most patients taking opioid painkillers are willing to fill a prescription for the opioid overdose antidote naloxone, a new small study suggests. Prescribing naloxone to patients taking opioid painkillers is increasingly recommended by medical guidelines, HealthDay reports. However, currently naloxone is not routinely prescribed to patients taking opioid painkillers, the article notes. The new study included 60 patients who received opioid painkiller prescriptions and were given prescriptions for naloxone. The study found 82 percent of patients filled their naloxone prescriptions. More than one-third of patients said they improved their drug-taking behavior after receiving naloxone. Some said they improved their handling of dosing and timing of doses. Three patients used naloxone to treat an apparent overdose.

Critics of the opioid overdose antidote naloxone say the treatment encourages repeated drug use, according to The New York Times. Many people overdose more than once, sometimes many times, and naloxone brings them back each time. Proponents of naloxone say it allows people to get into treatment. The nation’s death toll from opioids would be much higher without naloxone, the article notes. Lawmakers in every state except Kansas, Montana and Wyoming have passed legislation making the antidote easier to get. Dr. Alexander Y. Walley, an addiction medicine specialist at Boston Medical Center, told the newspaper that arguing naloxone encourages riskier drug use was like saying seatbelts encourage riskier driving.

Research funded by the National Institute on Drug Abuse (NIDA) found that patients taking opioids for long-term chronic pain, who were given prescriptions for naloxone in a primary care setting, had 63 percent fewer opioid-related emergency department visits after one year compared to those who did not receive prescriptions for naloxone. This study presents the first large published data regarding co-prescribing naloxone for primary care patients on long-term opioid therapy for pain. Primary care providers were more likely to give naloxone prescriptions to patients on higher opioid doses and with prior opioid-related emergency department visits. The findings suggest that prescribing naloxone in primary care settings is feasible and may offer an additional benefit to reducing opioid-related adverse events. Study authors indicate they do not know how many patients filled their prescriptions, and their analyses suggests a behavioral impact of naloxone co-prescription, as patients become more aware of the hazards of these...

Routinely prescribing naloxone to certain patients who take opioid medications might reduce the number of overdose deaths, a new study suggests. The study followed almost 2,000 people who were prescribed opioid painkillers for long-term pain at San Francisco clinics, HealthDay reports. About 38 percent were also prescribed the opioid overdose antidote naloxone. Patients were more likely to receive a prescription for naloxone if they were on a higher dose of opioids, or had experienced an opioid-related emergency room visit. Patients who received a naloxone prescription had 47 percent fewer opioid-related emergency department visits per month in the six months after receiving the prescription, and 63 percent fewer visits after one year, compared with patients who did not receive naloxone. Patients who received naloxone were told when and how to use the drug, which was provided in a nasal spray device. They were also told to ensure someone else knew where the...

The overdose antidote naloxone is becoming easier to buy around the country, the Associated Press reports. Most states have passed laws allowing people to buy naloxone without a prescription. Drugstores and other retailers are also making it more easily available. Until recently, naloxone, sold as Narcan, was available mostly through clinics, hospitals or paramedics and other first responders. “This saves lives, doesn’t seem to have any negative impact that we can identify, therefore it should be available,” said Dr. Corey Waller of the American Society of Addiction Medicine. CVS, Rite Aid, Walgreens, Target and Wal-Mart have made it easier to access naloxone through their pharmacies in many states, or are planning to do so, the article notes. The grocery chain Kroger sells naloxone without requiring a prescription in a few states. Naloxone has received attention recently after news reports that Prince was rescued from an overdose of the painkiller Percocet with...