“We need action now”: Push to improve access to overdose-reversing drug

A spike in overdose deaths and a “looming threat” of fentanyl has experts and councillors pushing for a life-saving drug to be made readily available.

The City of Melbourne has called for an overdose-reversing drug to be made readily available to prevent a growing number of “avoidable” deaths in the local area.

As an “emergency response” to recent data that showed two people died each month because of heroin-involved overdoses in the municipality in 2022, councillors unanimously backed a motion to improve access to the life-saving drug naloxone.

At the November 21 Future Melbourne Committee meeting, the motion presented by Cr Dr Olivia Ball urged the state government to act quickly on the issue and committed to hosting a roundtable of experts to identify the benefits of the medicine.

Described as a “life-saving” medicine, naloxone reverses opioid overdoses “almost instantly” and is seen as a safe, easy-to-administer drug.

It is currently only available in approved pharmacies, whereas other states around Australia have more extensive supply sites.

Experts addressed councillors at the meeting and argued there were little to no downsides to making the drug freely available.

“It doesn’t require a prescription and is easy for anyone to use – it’s a simple nasal spray administered into one nostril and that will safe a life,” Deputy Director of the Monash Addiction Research Centre in Melbourne, Professor Suzanne Nielsen, said.

“Extensive research shows that someone who witnesses an overdose, a lay person, can save a life if they have naloxone available, but naloxone can’t help if people can’t access it.”

Dr Dean Membrey, an addiction medicine specialist and general practitioner for community health organisation cohealth, told councillors naloxone had already made a sizeable impact.

“It has been amazing to witness our community’s response to take-home naloxone. It has saved lives, created a sense of empowerment in a community that often feels disempowered, and has reduced the strain on emergency services,” Dr Membrey said.

“For a period prior to COVID we had a tally-board of lives saved by our patient cohort and this reached tripled-figures. While on International Overdose Awareness Day there is always a sombre atmosphere as we remember the people we’ve lost, there is also now a glimmer of optimism and gratitude as we think of the people who are still with us due to take-home naloxone.”

However, he said the take-up rate of naloxone was not where it needed to be.

The recently released Coroners Court data now puts Melbourne (24 deaths in 2022) as having a higher heroin-involved fatality rate than any municipality in Victoria, overtaking Yarra and Brimbank council areas.

Dr Membrey said barriers to naloxone use meant people “continued to die unnecessarily”, and likened providing readily available naloxone in places where locals typically experience overdoses to providing cardiac defibrillators to those experiencing a heart attack.

The cohealth GP said the invention was crucial given an expected rise in use of fentanyl, a cheaper synthetic opioid far stronger than heroin that has proven catastrophic in North America and is expected to eventually arrive in Australia.

“[It’s] particularly important given the looming threat of fentanyl, which is likely to cause a significantly higher overdose rate than what we are accustomed to. However even without significant amounts of fentanyl on our streets, currently people continue to die of preventable causes of death right here in our community,” Dr Membrey said.

Victoria Police officers are currently not authorised to carry naloxone, which the motion noted was “a problem” given they are often first responders on the scene of an overdose, and it was urged they undertake a local pilot similar to what Western Australia Police had recently undertaken.

During this trial, 16 WA officers administered naloxone at least once during a 12-month period, and on each occasion the police intervention was successful, and no-one died.

Despite this, Police Association secretary Wayne Gatt was wary when asked about officers carrying the medicine.

“What we want to be careful about is that police aren’t administering drugs,” he said.

However, experts have argued that there should be few concerns, and that even if not administered properly naloxone did not pose as harmful.

Cr Dr Ball reiterated the low-risk nature of the drug, and argued the recent spike in deaths must trigger an “emergency response”.

“As the government of this municipality, we must respond,” she said.

“[Naloxone] cannot be used to get high, it is not addictive, it reverses the use of heroin and it’s harmless if given to someone who has not taken heroin.” •