NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update Acute

Naloxone take home doses

Opioid drug users are at a high risk of a drug related death on discharge from hospital. Services have been developed to ensure those with a current or previous history of opiate misuse are given overdose awareness training and a naloxone supply to use at home / in the community. Training within the community is offered within addiction teams, drug services, prisons and community pharmacies. From December 2015, naloxone will also be issued to high risk patients on discharge from hospital. 

 

Background

 

A guideline has been agreed for the provision of take home naloxone in an acute setting to individuals at risk of future opiate overdose. Naloxone, an opiate antagonist, is routinely used within the hospital setting to reverse the effects of opiates and is stocked in wards along with other emergency medicines. In 2005 following changes to the Medicines Act, naloxone was added to the list of parenteral prescription only medicines that can be administered by a member of the public for the purpose of saving a life in an emergency.  This allowed the development of take home naloxone programmes for individuals at risk of opiate overdose. In 2010 the Scottish Government announced the launch of the National Naloxone Programme. Patients with a current or previous history of opiate misuse are given overdose awareness training and a naloxone supply. Training within the community is offered within addiction teams, drug services, prisons and community pharmacies.

 

 

Opiate drug users are at a high risk of a drug related death on discharge from hospital. A history of non fatal overdose is also an identifiable risk factor.  In addition to provision within the community, the Scottish Government has recommended that those individuals at risk of future opiate overdose are supplied with naloxone on discharge from hospital.

 

Provision of overdose training and naloxone supply in hospital

Overdose awareness and naloxone training will be offered to patients who are identified through assessment by acute addiction liaison nurses as being at risk of future opioid overdose.  Training will be in the form of a brief conversation using a checklist.  On completion of training the acute addiction liaision nurse will request for a prescriber to add Prenoxad® to the immediate discharge letter to be dispensed by the hospital pharmacy. 

 

Prescribing and dispensing the correct product

Prenoxad® is a prefilled syringe containing 2mg/2ml of naloxone for intramuscular administration.  It is the only licensed take home naloxone product available and contains specific information leaflets and needles. Other naloxone products DO NOT contain needles and would be of no use in an emergency situation in the community.

 

Advice for medical, nursing and pharmacy staff

  • Naloxone MUST be prescribed as Prenoxad® for all supplies on discharge.
  • Prenoxad® should be dispensed in its original packaging including the cellophane, for all discharge prescriptions for naloxone. See guideline for labelling advice.
  • Prenoxad® must not be used as ward stock and should be segregated from other naloxone products that would be used in clinical areas.

 

If acute addiction liaison staff are unavailable, eg out of hours, further information on how patients can access naloxone within primary care is available in the Guidelines on the Management of Drug Misusers in Glasgow and Clyde Hospitals 2013-2016