In July 2022, Health Minister Mark Butler declared that the national rollout of the Take Home Naloxone (THN) program could prevent hundreds of deaths across the country.
“I’m really pleased that this initiative will be rolled out across the country and save hundreds of lives,” he said in a speech at the Pharmaceutical Society of Australia.
Naloxone, better known by its brand name Nyxoid or Narcan, temporarily blocks the effects of opioids and can be an effective tool to reduce fatal overdoses.
Naloxone is available as a nasal spray or injection and temporarily reverses the effects of opioids.
Naloxone has been available in Australia since the 1980s, but it has long been difficult to obtain due to barriers such as price, lack of stockists and required prescriptions, which hinder distribution.
Over the past decade, the federal government has attempted to remove these obstacles, but historically they have had little effect.
But two years ago, after a short trial, a new measure, the THN program, was introduced nationwide.
Under this program, anyone at risk of witnessing or experiencing an opioid overdose can receive naloxone for free through participating pharmacies and approved suppliers, the cost of which is federally reimbursed.
“This will remove all barriers to securing this life-saving drug for people who have suffered or witnessed an opioid overdose,” said then-Health Minister Greg Hunt said when planning the expansion.
Of the approximately 465,000 doses of naloxone distributed nationwide from July 2022 to October 2024, approximately 94% were delivered through pharmacies. (ABC News: Sam Nichols)
Since its introduction, $26.1 million has been invested in the program. As of September 30, approximately 465,000 doses of the vaccine had been dispensed. Of these, 54% were from January and 94% were through pharmacies.
Improving access to naloxone is an important step given reports such as: Increase in opioid-related deaths The same goes for emerging synthetic opioids like nitazen.
However, despite the program’s intentions to eliminate them, barriers to naloxone still exist. Across the country, people are reporting difficulty getting naloxone from pharmacies, being flatly refused or asked for a prescription, a fee, or both.
“Several times I was asked to get a prescription, only to be told one more time they wouldn’t give it to me,” said Sean, 26, who lives in Brisbane’s northern suburbs. he was 18 years old.
Between May and June last year, he was refused naloxone from five pharmacies.
“I paid $46…it’s supposed to be free,” said Tracy Lee, a NUAA peer volunteer based in Sydney’s southwest.
Outside of the THN program, Subsidized cost for naloxone is $31.60.
“I was told I needed a prescription. I was told it would cost $50 or $60. They looked at me very strangely and said something to the effect of, ‘Why do you need that medication?’ ” said Marianne Jancey, medical director of the Medically Supervised Injection Center in Sydney.
“Our work is not finished yet.”
One reason for lack of access is that pharmacists do not stock naloxone.
According to A study published in June A survey of pharmacies in Queensland, New South Wales, Victoria and Western Australia found that around 60 per cent had naloxone in stock.
Study author Suzanne Nielsen said this is an increase from 2016, when less than a quarter of pharmacists had naloxone on hand.
“Many positive steps have been taken, but the job of getting the word out about naloxone is far from done.”
Suzanne Nielsen has been researching naloxone and its availability for the past decade. (ABC RN: Jeremy Story Carter)
Professor Nielsen, who is also deputy director of the Monash Center for Addiction Research, has been researching naloxone and its availability for the past 10 years.
Her research found factors such as: Lack of supply, confidence in prescribing, and misconceptions that encourage riskier drug use This may contribute to why pharmacists avoid naloxone.
But another focus is on who naloxone attracts.
“We’ve conducted a number of studies over the years discussing naloxone with pharmacists and found that there is a stigma around the use of illicit drugs,” Professor Nielsen said.
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Stigma against drug use is a long-documented phenomenon within the health care system, including pharmacies.
In a new paper, Professor Nielsen found that pharmacists were more comfortable discussing naloxone with patients prescribed opioids than pharmacists who were misusing opioids.
“We are still seen as troublemakers,” said Elle Morrison, deputy CEO of the Australian Injecting and Illegal Drug Users Federation.
“That’s having a fixed view of the communities that are going to access naloxone, and also not really understanding the drug and the communities that want to access it.”
Knowledge gaps across the pharmacy industry
While one reason why pharmacists are shunned may be due to deeply ingrained prejudice, another reason could be confusion.
Research has previously noted that information gaps regarding naloxone exist across the pharmacy industry, including a lack of knowledge about both the drug and its dispensing to customers.
Research has long noted that knowledge gaps regarding naloxone exist across the Australian pharmacy industry. (ABC News: Matt Roberts)
“There is a real lack of education and a lack of communication within pharmacies,” said Rochelle Aylmer, NUAA’s Harm Reduction Services Manager.
In the course of her work, Ms Alimar contacted pharmacies across New South Wales and found that staff were unaware of both the THN program and how to administer naloxone, or believed the drug was irrelevant to their practice. I found a pharmacist who was
In May, harm reduction activists including Aylmer contacted more than 40 pharmacies across the Blue Mountains listed as stockists after reports that local residents were struggling to obtain naloxone. I took it. Only seven still had access to naloxone.
NUAA’s Rochelle Aylmer said she is aware that some pharmacists are withdrawing naloxone from stock due to an apparent lack of demand. (AAP: Lucas Koch )
Some pharmacy staff were unaware that they were listed as stockists, while pharmacists withdrew from the program due to demand.
“Some people admitted to having drugs in the past, but it wasn’t common. Some people had the impression that there was no community or network of drug users in the community,” she said. say.
However, few of the pharmacists contacted were interested in refilling naloxone.
“It was very concerning to us that pharmacies didn’t show much interest in adding it to their product suite.
“Soft launch”
Since the THN program’s rollout, little appears to have been invested in spreading awareness and information about the THN program. In 2022, Program pilot found there was no ‘widespread promotion’ For the wider community.
Online resources exist for naloxone and THN programs, but some pharmacists may not understand them well. (AAP: Lucas Koch)
According to government figures, of the $26.1 million investment, approximately $82,500 is earmarked for education and training modules.
” [THN] “The program itself… has been a bit of a soft launch,” said Australian Pharmaceutical Association New South Wales president Luke Kelly.
“I definitely feel it was well-intentioned…but a lot of people [pharmacists] I didn’t even know about that. ”
Although government-funded education and training modules are available online, the information may not reach enough pharmacists.
under consideration High workload and stress associated with the industrythose who don’t know about naloxone are unlikely to have the ability to become accustomed to it.
“Unless you have a direct interest in the field or patients, [who] Even if you need it, you think, ‘That’s not something you need to stock up on, that’s not something you should stock up on,'” Dr. Kelly says.
“I wish we had a better communication system, but I don’t know what that is.”
