Drug experts say lives will be saved when the drug Naloxone, which works as an antidote to opioid overdoses, becomes available over the counter in Australian pharmacies from Monday.



Deaths from prescription drug misuse account for a significant proportion of overdose deaths in Australia, with National Coronial Information System data showing 139 deaths in 2011 were associated with the opioid pain medication oxycodone. Many opioid overdoses also occur through using heroin.

Opioid-related overdose deaths are particularly pronounced in Victoria, with coroner’s court data showing that of 154 fatal overdoses involving illegal drugs in 2014, 135 involved heroin. Of 315 fatal overdoses involving pharmaceutical medications, 186 involved opioids.

In a bid to prevent some of these deaths, the Therapeutic Goods Administration has rescheduled Naloxone so people can get a single-use filled syringe of the drug over the counter, enough to reverse an opioid overdose.

Naloxone works by blocking the opioid from working on the brain and nervous system, while also reversing its effects on respiratory depression, which can cause people to stop breathing.

The chief executive of the health research organisation the Penington Institute, John Ryan, said one study had found another person was present in up to 60% of fatal opioid overdoses. But by the time an ambulance arrived or a prescription was obtained, it was sometimes too late to save those who had overdosed, he said.

“People should always still also call an ambulance if they or someone with them is suffering from an overdose,” Ryan said.

“But increasing the availability of Naloxone beyond emergency departments and ambulances is all about trying to prevent fatal overdoses, because it is the quickest and best way to reverse the effects of an opioid overdose.”

Ryan said most opioid overdoses were accidental. Sometimes people accidentally combined painkillers with alcohol, mistakenly took too much of their medication or overestimated how much of an illicit drug they could handle.

“The sooner you treat someone suffering an opioid overdose the better, because it’s not just death that is the worry but permanent brain damage and other injuries related to overdose.”

The TGA received 96 individual submissions in support of making Naloxone available over the counter from a pharmacist. All said Naloxone was safe and would have no effect on anyone without opioids in their system.

“The benefits of increasing availability of Naloxone outweigh the risks,” the TGA said in making its decision.

Australian Drug Law Reform Foundation director Dr Alex Wodak said while he welcomed the increased availability of the antidote, it was not sufficient to address Australia’s increasing abuse of opioids.

“Drug overdose deaths are risisng at totally unacceptable levels, and while Naloxone might make some difference, getting more people who are addicted to drugs into treatment would make a much bigger difference,” he said.

“Treatment is too limited in capacity and too inflexible in its design, and too much shaped by a drug prohibition environment.”

Last year the TGA recommended all over-the-counter medicines containing codeine, an opioid analgesic, be rescheduled to become prescription only. The regulator was due to make its decision in November, but because of the large number of submissions it received in response to the proposal it has deferred it until early this year.

If the recommendations are adopted, codeine-based medications will be available only through prescription from June.