Naloxone use by non-medical bystanders on the rise, but not fast enough

Use of a lifesaving drug to reverse opioid drug overdoses is growing, but not fast enough. That's according to new research in JAMA Network Open from The Ohio State University College of Medicine, College of Public Health and the National Registry of Emergency Medical Technicians.

In the first study of its kind, the research team looked at national use of naloxone by people without medical training to treat an opioid drug overdose. 

Naloxone is a lifesaving medication that can reverse opioid overdose effects when given immediately. Similar to CPR, stepping up to help before emergency crews arrive can be the difference between life and death."

Ashish R. Panchal, MD, PhD, clinical professor of emergency medicine and senior author

The study team evaluated two years of data from the National Emergency Medical Services Information System, the national emergency medical services (EMS) patient care record database. From June 2020 to June 2022, there were more than 96 million EMS activations from nearly 14,000 agencies across 54 states and U.S. territories. EMS reported 744,078 patients receiving naloxone with 24,990 of them getting it from an untrained bystander before EMS arrived.

"Our findings revealed that people receiving naloxone from laypersons increased by 43.5% proving that public health efforts are working," said Chris Gage, PhD student at the College of Public Health and corresponding author.

In the past 10 years, there have been a growing number of public awareness campaigns and improved access to naloxone for people without medical training. Last year, the Food and Drug Administration approved naloxone for over-the-counter use. Forty-six states and the District of Columbia provide legal immunity for Good Samaritans who help people experiencing an opioid overdose. 

"Unfortunately, the study found there is more work to be done since only 3.4% of EMS activations involving naloxone received it from non-medical bystanders," said Gage. "In a perfect world, this should be closer to a 100% highlighting a need to improve naloxone education, enhance access and investigate and remove obstacles to its use."

Future research will focus on the groups that are providing bystander naloxone and trying to understand delivery to patients in need.

Additional Ohio State authors are Jonathan Power; Alexander Ulintz, MD; Michael Lyons, MD; and Henry Wang, MD.