Here in Connecticut we record nonfatal overdoses that are reported through the 911 system. The big question we are always wondering is How many overdoses are there that are reversed with naloxone and 911 is never called?
A recent study out of Great Britain and Sweden offers a clue.
The study researchers enrolled 1025 people who used opioids and gave them take home naloxone kits. They were able to follow 594 of them over six months. Of the group 160 witnessed an overdose event, 90% said naloxone was available at the overdose scene. Naloxone was administered in 83% of the events. Yet in only 43% of the events where naloxone was administered was an ambulance called. When asked, some respondents said that 911 was not called for fear of the police. Reportedly other studies have shown similar rates of refusal to call 911.
Whether people are not calling 911 out of fear of police or their simple belief that the naloxone will work and EMS won’t be needed, from this study and all the anecdotal reports I have heard, there are clearly a large number of overdoses not being reported.
For surveillance purposes all we can track are fatal overdoses and 911 reported overdoses and that surveillance indicates overdoses are continuing to decline. I do believe with naloxone so prevalent and people who use drugs so comfortable using it, that we may be missing the true scale of the epidemic.
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For a Paramedic’s Guide to the Opioid Epidemic, check out my Book, The Family and Friends Guide to the Opioid Overdose Epidemic, available on Amazon in paperback and Kindle.
