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    Quit stigmatizing naloxone

    If vocabulary is the problem, change terminology and start saving lives

    Jeffrey FudinWhat do naloxone and epinephrine formulations for in-home use have in common? Both are lifesaving medications that have been around for more than 40 years. Naloxone, however, has at times been treated as the “redheaded stepchild” of emergency medicines, especially in connection with in-home use.

    Few pharmaceuticals can serve as antidotes, and fewer can be used in the home.

    Some that come to mind are parasympathomimetics such as neostigmine or edrophonium for tubocurarine exposure or myasthenia crisis respectively, antihistamines and epinephrine for anaphylaxis, flumazenil for benzodiazepines, etc.

    While mortality from anaphylaxis has declined over the years, in large part as a result of in-home availability of epinephrine1, mortality and morbidity from opioid “overdose” have increased sixfold.2

    As the number of cases of chronic pain and substance-abuse disorder continues to increase across the United States, opioid-related morbidity and mortality also continue to pose a costly and dangerous public health threat.

    The bee-sting analogy

    If someone allergic to bee stings were forced to become a beekeeper, would you deny that person an Epi-Pen?

    Did you answer no? Then why should naloxone be denied as the standard of care for chronic pain patients who can find no alternative for relief but opioids? 

    Many federal and state efforts have sought to increase access to naloxone and reduce liability risk through the passage of Good Samaritan laws.3,4 However, there remains a stigma associated with naloxone that poses a barrier to widespread prescribing.

    Jeffrey Fudin, PharmD, DAAPM, FCCP, FASHP
    Jeffrey Fudin, PharmD, DAAPM, FCCP, FASHP is a clinical pharmacy specialist, Stratton V.A. Medical Center, Albany N.Y., and adjunct ...
    Mena Raouf, PharmD Candidate 2016
    Mena Raouf is a 2016 PharmD candidate at Albany College of Pharmacy and Health Sciences, Albany, N.Y.

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