Doesn't naloxone distribution lead to "enabling?"
Researchers have studied this question. The result? No one has come up with evidence demonstrating that the net impact of naloxone distribution is lowered risk perception and greater opioid use (i.e. "enabling," or moral hazard).
Recently, a team of professors from Harvard, Stanford, and the University of Chicago felt it was so important to publicly discredit a poorly-designed study claiming evidence of naloxone-driven "enabling" that they co-authored a leading editorial in Health Affairs, the US's most prominent health policy journal. They wrote, "We find powerful reasons for skepticism regarding claims that naloxone laws created offsetting and self-defeating moral hazard effects...In the midst of America’s worst public health crisis since HIV/AIDS, one requires strong evidence indeed to claim that the net effect of the most prominent available tool to prevent opioid mortality is either zero or to cause harm. This is the health policy version of the 'first do no harm' principle."
Stepping back, people who don't use drugs, relying on their own intuition, might naturally assume that the availability of naloxone could encourage riskier opioid use. But the problem is that the intuition of people without drug use experience is not a good guide for predicting the behavior of people who use drugs. People who do have experience with drug use will tell you that the presence or absence of naloxone doesn't change the decision to use drugs--it just makes it possible to save someone's life in the event of an overdose.
don't we need a more comprehensive response to the opioid epidemic than just increasing naloxone distribution...one that includes getting more people into treatment and recovery?
YES! However, no single organization can solve all of the problems of this epidemic at once. Like in other areas of medicine, large-scale and enduring positive change will be the result of many excellent solutions to smaller aspects of the larger problem. For instance, the progress the US has made in preventing death from heart disease didn't come all at once when Pfizer launched Lipitor. It came with the development of angioplasty, and the decrease in smoking rates, and the normalization of statin use, and more widespread access to emergency medical services, and so on.
A successful response to the opioid crisis will be the same--it will need many excellent solutions to smaller pieces of the overall problem. The role of OCRF is to identify what interventions will save as many lives as possible, as quickly as possible as of right now, and to put together the pieces to act on them. For now, the under-supported intervention that still has the largest and fastest life-saving potential is community-based naloxone distribution.
CAN i get money from ocrf?
Probably not yet. OCRF is a start-up non-profit project. All the money we will grant out is money we'll have raised from scratch. OCRF is not a program within a larger philanthropic foundation that is starting out with a lot of money to deploy.
If you have the operations in place to distribute intramuscular (IM) naloxone to people who are currently opioid-dependent, recent overdose survivors, or people who detoxed in prison/jail and are now being released, and you need funding for naloxone supply, contact firstname.lastname@example.org.
Or, if you have statistically-significant, peer-reviewed evidence of an intervention to reduce opiate-related fatality that will save more lives, faster than naloxone distribution to people who are currently opioid-dependent, recent overdose survivors, or people who detoxed in prison/jail and are now being released, please share that evidence at email@example.com.
We're a small group trying to do a lot, and we apologize if we can't get back to you. If you don't hear anything in a couple weeks, please assume we can't help for now.
how can i get in touch with other questions, or to help you?
Send any correspondence to firstname.lastname@example.org. Again, we're a small group trying to do a lot, and we apologize if we can't get back to you. If you don't hear anything in a couple weeks, please assume we can't respond for now.