The TGA has recommended that naloxone minijet be scheduled to Pharmacist Only medicine—a decision which will likely save lives, says Angelo Pricolo, the Brunswick pharmacist who made the submission.
This would apply to naloxone when in single use prefilled syringe preparations for injection containing 400mg/mL of naloxone or less. The proposed implementation date is 1 February 2016.
“I’ve hoped that naloxone would be rescheduled to S3, but that didn’t seem to be happening, so I decided to make a submission myself to the TGA,” says Pricolo, who is a member of the PSA’s Harm Minimisation Committee and a National Councillor with the Pharmacy Guild.
“This is a huge decision in this sector, and something that’s been happening around the world in the last 12 to 18 months, in Europe, the USA and other different areas around the world.
“The realisation is growing that naloxone should be made more available, and what better way to do that than take the already-established network of pharmacies in Australia – with over 5,000 possibilities for it to be sold or made available?”
Pricolo says that currently, a person with an opioid addiction would need to see their GP to obtain a script for naloxone, have it filled and then give the naloxone to someone in their peer group or family to use in the event that the person overdoses.
“In 25 years as a practicing pharmacist I have never dispensed a naloxone minijet – and that means I’ve never received a prescription for it,” he told the AJP.
“The mechanism was there, but it just wasn’t happening in reality.
“If a person does overdose, obviously you can’t administer it to yourself. So the key is that this needs to be available to peers and to people in the network of that user, so that if the situation arises it’s more likely that the naloxone will be readily available – not just to prevent death, it’s not just about mortality but also the morbidity that may follow not acting quickly on an overdose.
“People may still survive but may have adverse effects long-term. So there’s lots of reasons we want it made more accessible.”
Pricolo says he hopes that the community, manufacturers and health professionals will all be able to access more education about harm minimisation strategies including naloxone and its use.
“There are still pharmacists and doctors out there who see anything to do with drug use as contrary to their moral judgement,” he says.
“Encouraging its acceptance and its proper use is going to take a bit of time.
“We also need to encourage pharmacists to understand that this isn’t a drug of abuse just because it’s used by drug users.
“There isn’t any potential for its misuse, and we don’t want a situation where somebody could potentially save a life with it but doesn’t have access because of an old scheduling regulation that says you need a prescription.”