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Harm reduction
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======Naloxone distribution====== [[Naloxone]] is a drug used to counter an overdose from the effect of [[opioid]]s; for example, a heroin or [[morphine]] overdose. Naloxone displaces the opioid molecules from the brain's receptors and reverses the [[respiratory depression]] caused by an overdose within two to eight minutes.<ref>{{Cite web |year=2013 |title=Get Started |url=http://naloxoneinfo.org/get-started/about-naloxone |url-status=dead |archive-url=https://web.archive.org/web/20140314005709/http://naloxoneinfo.org/get-started/about-naloxone |archive-date=14 March 2014 |access-date=17 March 2014 |website=Open Society Foundations}}</ref> The [[World Health Organization]] (WHO) includes naloxone on their "[[WHO Model List of Essential Medicines|List of Essential Medicines]]", and recommends its availability and utilization for the reversal of opioid overdoses.<ref>{{Cite web |year=2014 |title=Treatment of opioid dependence |url=https://www.who.int/substance_abuse/activities/treatment_opioid_dependence/en/ |url-status=live |archive-url=https://web.archive.org/web/20140314012311/http://www.who.int/substance_abuse/activities/treatment_opioid_dependence/en/ |archive-date=14 March 2014 |access-date=17 March 2014 |website=World Health Organization |publisher=WHO}}</ref><ref>{{Cite web |year=2014 |title=Drug use prevention, treatment and care |url=http://www.unodc.org/unodc/en/drug-prevention-and-treatment/index.html |url-status=live |archive-url=https://web.archive.org/web/20200910123842/http://www.unodc.org/unodc/en/drug-prevention-and-treatment/index.html |archive-date=10 September 2020 |access-date=17 March 2014 |website=United Nations Office on Drugs and Crime |publisher=UNODC}}</ref> Formal programs in which the opioid [[inverse agonist]] drug naloxone is distributed have been trialled and implemented. Established programs distribute naloxone, as per WHO's minimum standards, to people who use substances and their peers, family members, police, prisons, and others. These treatment programs and harm reduction centres operate in Afghanistan, Australia, Canada, China, Germany, Georgia, Kazakhstan, Norway, Russia, Spain, Tajikistan, the United Kingdom (UK), the United States (US), Vietnam,<ref>{{Cite web |last1=Paul Dietze |last2=Simon Lenton |date=December 2010 |title=The case for the wider distribution of naloxone in Australia |url=http://www.atoda.org.au/wp-content/uploads/The_heroin_reversal_drug_naloxone_FIN2.pdf |url-status=dead |archive-url=https://web.archive.org/web/20130411150232/http://www.atoda.org.au/wp-content/uploads/The_heroin_reversal_drug_naloxone_FIN2.pdf |archive-date=11 April 2013 |access-date=30 March 2013 |website=Alcohol, Tobacco & Other Drug Association ACT |publisher=ATODA}}</ref> India, Thailand, Kyrgyzstan,<ref>{{Cite web |year=2013 |title=Tools for Starting a Naloxone Program |url=http://naloxoneinfo.org |url-status=dead |archive-url=https://web.archive.org/web/20140317165651/http://www.naloxoneinfo.org/ |archive-date=17 March 2014 |access-date=17 March 2014 |website=Open Society Foundations}}</ref> Denmark and Estonia.<ref>{{Cite web |date=14 October 2014 |title=Take home naloxone to reduce fatalities: scaling up a participatory intervention across Europe |url=https://www.emcdda.europa.eu/event/2014/10/take-home-naloxone-reduce-fatalities-scaling-participatory-intervention-across-europe_en |website=European Monitoring Centre for Drugs and Drug Addiction |location=Lisbon}}</ref> Many reviews of the literature support the effectiveness of naloxone based interventions in reducing overdose deaths where it is available at the time of the overdose event.<ref>{{Cite journal |last1=Mueller |first1=Shane R. |last2=Walley |first2=Alexander Y. |last3=Calcaterra |first3=Susan L. |last4=Glanz |first4=Jason M. |last5=Binswanger |first5=Ingrid A. |date=3 April 2015 |title=A Review of Opioid Overdose Prevention and Naloxone Prescribing: Implications for Translating Community Programming Into Clinical Practice |journal=Substance Abuse |volume=36 |issue=2 |pages=240β253 |doi=10.1080/08897077.2015.1010032 |pmc=4470731 |pmid=25774771|bibcode=2015JPkR...36..240M }}</ref><ref>{{Cite journal |last1=McDonald |first1=Rebecca |last2=Strang |first2=John |date=30 March 2016 |title=Are take-home naloxone programmes effective? Systematic review utilizing application of the Bradford Hill criteria |journal=Addiction |volume=111 |issue=7 |pages=1177β1187 |doi=10.1111/add.13326 |pmc=5071734 |pmid=27028542}}</ref> This effectiveness has been explained in a [[Realist Evaluation]] which explained the effectiveness through [[bystander effect]], [[social identity theory]], and skills training such that universal access to training supports social identity and in-group norms (of people who use drugs), which supports the conditions for the success of a peer-to-peer distribution model of naloxone-based interventions. Stigma and stigmatising attitudes reduced the effectiveness of naloxone based interventions.<ref name="hrjrealistreview">{{Cite journal |last1=Miller |first1=Nicole M. |last2=Waterhouse-Bradley |first2=Bethany |last3=Campbell |first3=Claire |last4=Shorter |first4=Gillian W. |date=23 February 2022 |title=How do naloxone-based interventions work to reduce overdose deaths: a realist review |journal=Harm Reduction Journal |volume=19 |issue=1 |page=18 |doi=10.1186/s12954-022-00599-4 |pmc=8867850 |pmid=35197057 |doi-access=free}}</ref>
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