Take home naloxone pilot.

The Australian Government is investing in a pilot program to make naloxone available free to people who may experience, or witness, an opioid overdose.

For information about the Naloxone pilot program, including how to use Naloxone, how to supply Naloxone, and who is at risk of an opioid overdose, visit the Department of Health website here.

What is naloxone?

Naloxone is a drug that can temporarily reverse the effects of an opioid overdose or adverse reaction. If someone has overdosed on opioids they will be unconscious or awake, but unable to talk. It’s unlikely they will be able to administer naloxone themselves. Naloxone can administered by injection or delivered through a nasal spray.

What is an opioid overdose or adverse reaction?

A person who has taken either a large amount of opioids or some strong opioids can overdose or experience an adverse reaction. They may be:

• unconscious
• unresponsive
• awake, but unable to talk
• vomiting
• making choking sounds, or a snore-like gurgling noise

They may also have:

• stopped breathing or have slow, shallow or erratic breathing
• bluish purple skin (in lighter skinned people) or greyish or ashen skin (for darker skinned people)
• a limp body
• a pale or clammy face
• blue or purplish black fingernails and lips
• slow, erratic or no pulse (heartbeat)

If someone at risk is making unfamiliar sounds while ‘sleeping’, try to wake them up in case they have overdosed.

Who is at risk of an opioid overdose or adverse reaction?

People who are dependent on opioids are at higher risk of an overdose if their tolerance to the drug is reduced. This can happen if they stop taking opioids for a while (for example if they have been in drug treatment or in prison).

Other risk factors include:

• using opioids in high doses with other sedatives — for example, benzodiazepines
• some medical conditions — for example
  • depression
  • HIV
  • liver disease
  • sleep apnoea
  • lung disease, such as chronic obstructive pulmonary disease or pneumonia
• living in a home where opioids are stored

What is the take home naloxone pilot?

The Australian Government is investing $10 million in a Take Home Naloxone Pilot. Under the pilot, naloxone will be available free to people who may either experience, or witness, an opioid overdose. No prescription will be required.

Who is the take home naloxone pilot for?

The take home naloxone pilot is for:

• people who are at risk of an opioid overdose or adverse reaction, their carers, friends and family members
• approved providers such as community pharmacists, dispensing doctors and hospital pharmacists

Where will naloxone be available under the take home naloxone pilot?

Naloxone will be available in New South Wales, South Australia and Western Australia.

Each state will identify where naloxone will be available within their state. Sites may include:

• community and hospital-based pharmacies
• alcohol and drug treatment centres
• needle and syringe programs

Find out where to access naloxone.

How long will the take home naloxone pilot run?

The take home naloxone pilot will start on 1 December 2019 and run through to 28 February 2021.

Why is the take home naloxone pilot important?

Opioid use is a major cause of hospitalisation and death in Australia:

• Every day, 3 people die from drug-induced deaths involving opioid use in Australia, while nearly 150 hospitalisations and 14 emergency department admissions involve opioids.
• More than 110,000 Australians are currently struggling with opioid dependence.
• In 2018, 1,740 people died from drug-induced deaths, with opioids present in 1,123 of those deaths (64%).

Who is involved in the take home naloxone pilot?

The take home naloxone pilot is funded by the Australian Government. The Department of Health is overseeing the pilot and working with the state governments of New South Wales, South Australia and Western Australia to implement it.

What to do if someone overdoses and you have naloxone

Administer the naloxone and call 000 for an ambulance immediately.

Is it safe to use opioids to manage my chronic pain through the COVID19 pandemic?

The use of high doses of opioids may pose a higher risk for more severe disease severity with COVID-19 due to associated side effects such as the potential for decreased immune responses, sleep-disordered breathing, ventilatory impairment in post-operative and obese groups, and some indications of pathophysiological causes for the increased risk of pneumonia. 

If you are taking opioids regularly for pain and develop symptomatic COVID-19, your clinical team may consider a careful opioid dose reduction (but not full withdrawal) because of the potential for heightened sensitivity to adverse effects, including the potential for respiratory function depression.

However it is important to note that the link between COVID-19 and opioid use is purely speculative, given a lack of any published data looking specifically at associations between COVID-19 and opioid use.

It is also important to note that rapid opioid dose reduction also poses risks including more severe pain and neuro-psychological effects so you should not make any changes to your usual medication and should follow careful consideration of dosage only in consultation with a prescribing practitioner.

You can also access Naloxone, a drug that can temporarily reverse the effects of an opioid overdose or adverse reaction, as a precautionary measure. The drug is available for free, no prescription needed.  Know more about the Take Home Naloxone program here: About the Take Home Naloxone program | Australian Government Department of Health and Aged Care

I cannot access my usual pain management team right now. What can I do to manage my chronic pain?

Due to the COVID-19 pandemic, many clinics and health professionals are limiting face to face consultations to minimise the risk of infection.

The Federal Government has announced a major expansion of telehealth services that has ensured ongoing access to care during these times of social distancing. From 13 March 2020 to 30 September 2020 (inclusive), new temporary MBS telehealth items have been made available to help reduce the risk of community transmission of COVID-19 and provide protection for patients and health care providers.

The new temporary MBS telehealth items are available to GPs, medical practitioners, nurse practitioners, participating midwives and allied health providers. The bulk billing incentive Medicare fees have temporarily doubled (until 30 September) for items relating to General Practice, Diagnostic Imaging and Pathology services. These items can be claimed with the telehealth items where appropriate.

Telehealth access will reduce healthcare workers’ and patients’ exposure to infection and enable you to continue to access your multidisciplinary pain management team. You should contact your current provider to see if you can access services through telehealth.

GPs and other medical practitioners must bulk-bill the COVID-19 telehealth and telephone consultation services where the service is provided to a concessional or vulnerable patient or a child under 16.

Face to face consultations are also still available in many practices, so speak to your health practitioner to learn more on how they can best support you.

Prescribing 

Interim arrangements are now in place for prescribing to make supply of medicine more convenient following a telehealth consultation.  

Under the interim arrangements, a digital image (such as a photo, scan or pdf) of a prescription can be sent electronically by the prescriber to your pharmacy of choice. This electronic copy can be used by the pharmacy to supply the medicine and claim from the PBS in the same way as a paper prescription. The pharmacy may communicate directly with the you to arrange payment and to organise collection or home delivery of the medicines. 

Alternatively, the paper prescription can be sent by post to you. The prescription can then be taken to a pharmacy by a family member or friend.  The Australian Government has announced the interim arrangements for prescribing will remain in place until 30 September 2020, or until full electronic prescribing rollout is implemented.  

For more information, visit About the Take Home Naloxone program | Australian Government Department of Health and Aged Care

I am on a high dose of opioids to manage my chronic pain condition. What can I do to minimise my risks?

It is important to note that the link between COVID-19 and opioid use is purely speculative, given a lack of any published data looking specifically at associations between COVID-19 and opioid use.

It is also important to note that rapid opioid dose reduction also poses risks including more severe pain and neuro-psychological effects so you should not make any changes to your usual medication and should follow careful consideration of dosage only in consultation with a prescribing practitioner.

If you are concerned about the risks of high doses of opioids during the pandemic, always speak to your prescribing GP or health practitioner first. Telehealth services are now available with nearly 99 per cent GP’s now offering consultations via phone or video.

For more information, visit About the Take Home Naloxone program | Australian Government Department of Health and Aged Care