The Corner

Health Care

Are Anti-Overdose Drugs Backfiring?

Cataldo Ambulance medics Paula Gageiro and Al Driscoll take a man who overdosed on opioids, to an ambulance in Revere, Mass., November 8, 2017. (Brian Snyder/Reuters)

Yes, says an incredibly depressing new study. It suggests that opioid abuse rises when overdose-reversing drugs are easily accessible.

This could happen through two different mechanisms: “(1) saving the lives of active drug users, who survive to continue abusing opioids, and (2) reducing the risk of death per use, thereby making riskier opioid use more appealing.” (1) isn’t a bad thing, even though we would obviously prefer that addicts quit after nearly dying. But (2) is a serious problem, as it could mean that overdose-reversing drugs don’t actually save lives on balance.

As the authors note,

Media reports o ffer anecdotal evidence of these eff ects. Stories about Naloxone parties — where attendees use heroin and prescription painkillers knowing that someone nearby has Naloxone in case they overdose — have worried legislators. News reports also highlight cases where police find Naloxone alongside opioids when they search a home or car, and quote first-responders who are frustrated that the same individuals are saved again and again by Naloxone without getting treatment.

To study these possibilities in more detail, the authors looked to see what happened when states passed laws making Naloxone easier to access. The results:

After Naloxone access laws take eff ect, Google searches for “drug rehab” (a proxy for interest in drug treatment) fell by 1.4%, arrests for possession and sales of opioids increased by 17% and 27%, respectively, opioid-related visits to the emergency room increased by 15%, and opioid-related theft increased by 30%. Meanwhile, expanding access to Naloxone had no eff ect on opioid-related mortality, on average.

They say “on average” because the law actually seemed to increase mortality in one region, the Midwest.

The silver lining is that the results varied with the availability of drug treatment. There’s evidence, albeit only suggestive evidence, that “Naloxone access increases opioid-related mortality in places with limited treatment and decreases it in places with more treatment.”

One should never make too much of a single study. Indeed, the authors note that another study reached the opposite conclusion, though they argue that their own work is superior. But these findings undermine what seemed like a promising weapon in the fight against the opioid epidemic.

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