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Tuesday, April 12, 2011

Heroin overdose antidote should be given to prisoners, ministers told

Heroin overdose antidote should be given to prisoners, ministers told

The government's official drug advisers say 'magic medicine' naxolone could save 500 lives a year

One in eight prisoners take a heroin overdose within two weeks of leaving jail, Les Iversen said. Photograph: Mykel Nicolaou/Rex Features

The government's official drug advisers are urging ministers to provide all prisoners at risk of overdosing with a "magic medicine" that could save up to 500 lives a year.

The Advisory Council on the Misuse of Drugs (ACMD) wants to see all prisoners leaving jail in Britain handed packs of naxolone which reverses the symptoms of a morphine or heroin overdose for 45 minutes, which could be long enough to get emergency treatment.

Professor Les Iversen, the ACMD chairman, is pressing Home Office and Department of Health ministers to make the drug available to prisoners across England and Wales to tackle the problem that one in eight prisoners take a heroin overdose within two weeks of their release.

"A single injection can bring them back to life again. It really is a magic medicine," Iversen told an open meeting of the ACMD in London on Tuesday.

"It is safe and it is very unlikely to be misused as it has the opposite effects to the opiates." He said about one in 200 heroin injectors died within a fortnight of leaving prison.

Scotland is pioneering the use of the drug to tackle overdose-related deaths. The Scottish government is about to spend £500,000 to fund the distribution of 10,000 units of naxolone in kits that can be administered by family members and carers who can be trained to inject the antidote.

David Liddell of the Scottish Drugs Forum told the ACMD meeting in London that Scotland had the highest drug-related death rate in Europe. "Quite a number of the 500 drug-related deaths a year in Scotland could be prevented by the use of naxolone," he said.

The kits are distributed in Scotland through needle exchanges as well as to prisoners thought to be at risk of a drug overdose when they resume using street heroin immediately after their release. More than half the 450 regular users of the Inverness needle exchange are being given naxolone kits.

"You can't recover if you are dead. This should be seen as part of the recovery approach to drug treatment. I would urge other parts of the UK to look at this situation," said Liddell.

The pilot schemes in Scotland have had critics. Professor Neil McKeganey, of Glasgow University's Centre for Drug Misuse Research, has said: "The real worry is that if you give addicts a drug that can reverse the effects of a heroin overdose, there is a real possibility that some addicts will be prepared to use higher dosages of heroin, confident that they can reverse the effects if they need to."

But the government's drug experts have also been impressed by the results of a London pilot scheme conducted for the National Treatment Agency. The Welsh assembly also established some "demonstration sites" for take-home naxolone about 18 months ago.

The ACMD chairman said there were legal issues with the national availability of naxolone. At present a prescription could only be made out for a single user but he said it was important to get the kits into the hands of family or friends. "It is important that it is widely available," he said. "If the user keels over he can't inject himself. It would need to be administered by a friend or family member."

Drug treatment workers reported that they were being lobbied particularly by the mothers of problem drug users who would welcome having the kits at home in case their son or daughter took an overdose

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