COMMENTARY

Should People Carry Naloxone to Prevent Opioid Overdose?

Arthur L. Caplan, PhD

Disclosures

May 04, 2018

Hi. I am Art Caplan. I am at the Division of Medical Ethics at the NYU School of Medicine.

How bad is the opioid epidemic in the United States? Here is a statistic that just blew me away and reveals just how awful things are. As recently as 10 years ago, about 1% of people who wound up as organ donors when they died did so because of an overdose. A study just came out and the researchers determined that 13% of all organ donors today, when organs are taken from the dead, are due to a drug overdose.

That is an incredible number. It gives an indication of just how out of control and terrible this opioid epidemic is. It is killing young people, because they are the ones who often wind up serving as organ donors.

This high percentage of organ donors raises some obvious questions. For one, it is doubtful that any of the people who overdosed took the time to let their wishes be known about organ donation. It means that families who may not have had contact with someone who died owing to opioid overdose are going to have to make decisions about organ donation.

There are a lot of terrible circumstances around which people have to make decisions about organ donation, such as car accidents, swimming pool accidents, lots of terrible situations. But these are often families who have not seen the person who died for a long time. They are ridden with anger, guilt, all kinds of emotions when their young loved one dies.

It is just tough in terms of getting a real informed consent and asking them to do what the person would have wanted done when it comes to organ donation. I am not saying that we should not be asking, but it is clear that we are going to have to exercise some real sensitivity when it comes to approaching family members of someone who died of an overdose.

What can we do about the overall epidemic? It is supplying a lot of organs, but the reality is we want to get rid of the deaths that may diminish the number of available organs; the priority is to prevent people from dying. The obvious thing is we have to spend more money. Sadly, we have not seen enough leadership from the White House and Congress yet to put real money into battling the opioid epidemic. I hope that some settlements are reached with some of the companies that marketed opioids irresponsibly so that we get funds, much like the tobacco funds, that will let us set up programs to help get people off of these drugs.

The Surgeon General had an idea that I support fully, and that is to make sure that people carry naloxone. We should have the antidote available easily when someone overdoses. If you know someone who has a drug problem, if there is someone in your family who has a drug problem, I think you should keep an injectable in your house. I think you need to learn how to use it and how to administer it. After all, we do this for people with allergies. We have kids with allergies to bee stings or peanuts, and people keep the antidotes handy. They are ready to vaccinate when they need to do that to reverse an allergic reaction. I think we have to do the same thing when there is an opioid risk.

I also think that these kits should be available not only to the police and fire departments, but at your church, at high schools, anywhere that people gather if somebody winds up having a problem.

I am told that a lot of our fast-food places are locking their restrooms because they do not want people dying there of opioid overdoses. That tells me we have got to get this antidote out there as broadly as we can, and we have to make sure that no one cannot get it because they cannot afford it. Some attention has to be paid to price.

The opioid epidemic is taking a horrible toll on Americans. It is basically accounting for far too many organ donations from the dead. We need to do what we can to reverse that. One thing we can do is encourage people to have the antidote to an overdose readily available in public places and in the home. I think that is an obligation that we ought to carry out.

I am Art Caplan. I head the Division of Medical Ethics at NYU School of Medicine. Thank you for watching.

Talking Points: Should People Carry Naloxone to Prevent Opioid Overdose?

Issues to consider:

  • Every day, more than 115 people in the United States die after overdosing on opioids.[1]

  • Opioid overdoses increased 30% from July 2016 through September 2017 in 52 areas in 45 states.[1]

  • Some healthcare professionals are concerned that people won't be able to administer naloxone without training; if they try to administer naloxone and aren't able to do so correctly, that could delay calls for emergency assistance and result in an overdose death.

  • Some healthcare professionals contend that the government's efforts to encourage use of naloxone is diverting attention from the fact that what is needed are educational programs to teach people about the dangers of opioids.

  • Some healthcare professionals are concerned that some patients who die of opioid overdoses may not have told a family member about their end-of-life wishes or aren't in touch with family members who could give consent to donate an organ.[2]

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....