title: Take-home naloxone to reduce heroin death.
abstract: BACKGROUND
  This paper reviews the relevant literature related to the distribution of take-home naloxone.
  
  
  METHODS
  A Medline search was conducted on articles published between January 1990 and June 2004 to identify scientific literature relevant to this subject. Those publications were reviewed, and from them other literature was identified and reviewed.
  
  
  RESULTS
  The prevalence, pathophysiology and circumstances of heroin overdose, and also bystander response are included in this review. Naloxone peer distribution has been instituted to varying degrees in the United States, Italy, Spain, Germany and the United Kingdom.
  
  
  CONCLUSIONS
  At this point the evidence supporting naloxone distribution is primarily anecdotal, although promising. Although the distribution of naloxone holds promise for further reducing heroin overdose mortality, problems remain. Naloxone alone may be insufficient in some cases to revive the victim, and cardiopulmonary resuscitation (CPR), especially rescue breathing, may also be needed. A second dose of naloxone might be necessary. Complications following resuscitation from overdose may infrequently need in-hospital care. Mortality from injecting without anyone else present will be unaffected by take-home naloxone. Take-home naloxone should be studied in a rigorous scientific manner.
authors.affiliation: Center on Alcoholism, Substance Abuse, and Addictions (CASAA) and Family and Community Medicine, University of New Mexico, Albuquerque, USA. baca5@unm.edu
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Baca
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Grant
mesh_terms: D024201:Bystander Effect; D062787:Drug Overdose / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D006556:Heroin Dependence / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*
chemical_list: D009292:Narcotic Antagonists; D009270:Naloxone