Policy prevented Limerick worker from administering life-saving drug to addicts

Fintan Walsh

Reporter:

Fintan Walsh

Rachel O’Donoghue, of Ana Liffey Project, has called for naloxone to be made prescription-free Picture: Adrian Butler

Rachel O’Donoghue, of Ana Liffey Project, has called for naloxone to be made prescription-free Picture: Adrian Butler

A DRUG project worker was unable to administer a life-saving medicine to two addicts suffering a heroin overdose in Limerick city because Ireland’s “narrow law” prohibits non-drug users from carrying it.

Speaking at City Hall, Ana Liffey Project team leader Rachel O’Donoghue called for the drug naloxone to be made prescription-free. 

Naloxone can be used to stabilise a drug user who is experiencing an opioid overdose, and is understood to come at a small expense to the taxpayer.

However, since the drug was introduced on a pilot basis in Limerick in 2016, medical experts and outreach workers have been critical of the policy surrounding its prescription.

Only a drug user can be prescribed the needle or nasal form of naloxone by an authorised GP. In 2017, there was only one GP in the Mid-West who could prescribe the drug, and that was Cecil Street-based Dr Patrick O’Donnell.

This figure has now increased to more than a dozen. The restrictive measures, however, mean that if a prescribed drug user suffers an overdose, a trained individual will have to hope that the drug user is in possession of naloxone.

Ms O’Donoghue was speaking at a discussion on how Limerick is tackling its overdose problem this Monday, as part of Overdose Awareness Day, convened by Metropolitan Mayor Cllr Daniel Butler.

“In early August, one of our project workers was on outreach in Limerick city, and in one week [she] came across two overdoses in the city centre. On both occasions, unfortunately, the drug users didn’t have naloxone on them. So [she] contacted the ambulances, and luckily they arrived very speedily, and both were taken to hospital and recovered.

“But it would have been a huge support to us if she was able to bring naloxone on her. And besides, ambulances can be delayed, there are shortages.”

When a drug user is suffering from an overdose, heroin attaches to nerve receptors that control breathing and can lead to respiratory attacks.

When naloxone is administered, the receptors are detached and the drug user is then stabilised.

“While there is fantastic work being done, we can’t ignore the fact that Ireland has got the fourth highest rate of overdose in Europe [in 2015],” she said.

A total of 348 people died from heroin overdoses that year, double the number of people killed in road traffic collisions nationwide.

“It’s horrendous. And just remember, behind every death, there is a loved one suffering. There are some changes that could be made nationally for us to reduce overdoses further, and I am calling for action for these changes to be made.”

She said it was an exciting time for services to avail of naloxone. 

“However, we want to call today for a prescription-free naloxone. Currently, only a drug user can be prescribed naloxone. That means project workers can’t carry naloxone on them. Family members and friends can’t carry naloxone on them.”

The talk comes just days after the HSE rolled out the new naloxone nasal spray, which is safer, in terms of physical safety and infection prevention and control. Dr Patrick O’Donnell said one of the “biggest challenges” he faces as a GP is the prescription of naloxone. 

“The commonest question I get asked about naloxone is, why did you give it to the person who is at risk of overdose? Why didn’t you give it to their partner or to their mother or father or to a person who is going to be using it [opioid] with them. And the answer is the law says I have to give it to the person who is at risk. In truth, if that person overdoses, they are not going to be able to inject themselves or use the nasal spray themselves,” he said at City Hall.