Just 60% of pharmacies stock naloxone, a life-saving medication that rapidly reverses the effects of an opioid overdose, as concerns grow about the danger posed by synthetic opioids.
A survey of 530 pharmacies across New South Wales, Victoria, Queensland and Western Australia, led by researchers from Monash University, found 321 pharmacies have naloxone in stock.
A co-author of the study and deputy director of the Monash Addiction Research Centre, Prof Suzanne Nielsen, said this was an improvement from 2016, when only 23% of pharmacies stocked naloxone. But she said with unintentional opioid-related deaths in Australia nearly tripling since 2006, more pharmacies should stock naloxone.
The findings are being presented at a research symposium being held by the centre on Thursday.
The introduction of the national Take Home Naloxone program in 2022 means anyone can access the drug from a pharmacy free, without a prescription, with people at risk of an opioid overdose or adverse reaction, their carers, friends and family members encouraged to have it on hand.
Nielsen said she was aware of pharmacies that had not received information about the program, which demonstrated the need for additional support.
“We’ve seen great gains in Australia … the fact we have a nationally funded program is quite unique globally,” she said.
“We’re aware implementing new programs takes time … but we still need to do the necessary work to make sure that the other 40% of pharmacies can provide naloxone.”
The survey is an update to the centre’s research published on Thursday in the medical journal, Drug and Alcohol Review, which found only 38% of Victorian pharmacies stocked naloxone in 2020, and a third of which had not supplied their stock to any customer in the past year.
Nielsen and her colleagues found that pharmacists lacked the training necessary to confidently identify at-risk patients and supply naloxone over the counter.
Synthetic opioids, known as nitazenes, are mixed into other drugs like MDMA and heroin without the user’s knowledge.
A cluster of 20 drug overdoses in NSW in April prompted the state’s health department to issue a public warning about the danger of synthetic opioids, which are often substantially more powerful than heroin and to promote the importance of take-home naloxone.
Nielsen called for naloxone to be part of the mainstream first aid response, particularly in environments like festivals where illicit drugs that “may or may not contain synthetic opioids” are more common.
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“It’s amazing that we have this medication that can reverse an opioid overdose and be administered by a person with very little training,” she said, with naloxone easily administered through injection or nasal spray.
Dr Paul MacCartney, an addiction medication specialist at the Melbourne not-for-profit health service CoHealth, said heavy stigma around opioid use within both the general public and medical profession hindered naloxone’s availability.
“The most popular newspaper in our city ran an active campaign against people who use drugs in order to prevent a second safe injecting room being implemented … and that stigma persists in society through the medical profession,” he said.
On 23 April the Victorian government rejected a proposal for a second safe injecting room, which was to be located in the city, after a strong backlash from some media outlets and members of the public.
MacCartney said pharmacists were under the impression that opioid users were more likely to be aggressive.
“People who use drugs are on edge when they go into a medical setting … they may not even feel comfortable asking a pharmacist for naloxone for fear they might be judged,” he said.
He called for pharmacists to be “proactive” in offering the medication to those at risk of an overdose. He also suggested that naloxone be given out alongside prescription opioids, as in Australia, more people die from overdoses of prescribed opioids compared with illicit types.