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To the best of my knowledge there is no research evaluating the efficacy of simply handing out naloxone to potential opiate abusers. The study I am aware of was reported on in EMRAP years ago and involved a concerted effort in a community in the Boston area, where addicts and their caregivers signed up for a course in education of CPR, BLS recognizing opiate OD, the use of naloxone....and this education took some time...I believe at least a few separate days of education...this was followed by evaluating the efficacy of the program and indeed they did see a decrease in OD deaths. This study did not simply hand out naloxone with a 5 minute spiel on how to use it. The cohort in the study is likely markedly different then the random ED opiate user...the cohort in the study is likely a much more responsible group to have taken the time the participation in that program required. I am not so certain we will, do more good them harm with this random handing out of a reversal agent....kind of like sex education in schools in the 70's ended up leading to higher rates of STDs and unwanted pregnancies...sometimes the best intentions go awry. I think we should have a study where we do what you are suggesting first before we suggest that we adopt that as standard ER policy.
What you do matters.