I know from our work on the health committee with the Minister of State, Deputy Burke, that he is well aware of the urgent crisis we have with drug deaths in this country. We have very high levels of injury due to the use of illicit drugs.
One of the tools in combating risk of death and injury is to use drugs such as naloxone to stabilise someone during a usage crisis or an overdose. Ireland currently regulates naloxone in a way that makes it practically very difficult for users, service providers and clinical staff to access. Other countries have started to look at the regulation of naloxone. Given that Ireland has some of the highest levels of drug deaths in the European Union, we should very much be leading the way here.
Naloxone is a medicine which rapidly reverses an opioid overdose. It is an opioid antagonist, which means it attaches itself to opioid receptors and reverses and blocks the effects of other opioids. That essentially means it has no opioid effect in and of itself. Somebody who has not taken an opioid could pick it up off the ground, find it and take it, and it would have absolutely no effect on them. For a person in addiction who is experiencing overdose, naloxone can quickly restore normal breathing if their breathing has slowed or stopped because of that overdose. Again, naloxone has no effect on someone who does not have opioids in their system. It is not a treatment for opioid use disorder and has no street value, but it can be used in overdose crises including heroin, fentanyl, oxycontin, hydrocodone, codeine and morphine. Naloxone can be given to any person who shows a sign of an opioid overdose, or even when an overdose is suspected. In Ireland, it is often given as a nasal spray. In cases of nitazenes, which are the new danger and the things we all fear, it increasingly seems that we need three to four doses of naloxone to combat an overdose. One can therefore understand how strong nitazenes are in that case. Often, people simply cannot access the drug in time.
At the Committee on Drugs Use in September, the huge importance of naloxone was discussed with the Irish Pharmacy Union and the Irish College of General Practitioners, ICGP. Both organisations were clear in their support for reviewing access to naloxone. I want to be careful not to miscategorise anything they say on the issue so I will quote what they said. The ICGP said:
At the ICGP, we fully recognise the excellent safety profile of naloxone, so we would be very supportive of removing prescription requirements.
When I asked a representative of the Irish Pharmacy Union if access to naloxone was an issue, he replied:
Correct, and that is where we would have to go back to our Irish Medicines Board, IMB, laws with regard to making the drug no longer require a prescription.
When I put it to him that we have undertaken to install defibrillators across the country - one can access them with a code on the street - he engaged with the suggestion as the kind of level of access we want.
Prior to the UK’s departure from the EU and while it was still within the European Union, England introduced a measure whereby people could walk into any pharmacy and get the drug without a prescription. Anyone could access it that way. Ideally, that is the way the product would be accessed. One would not require a prescription. Any family member, friend of somebody who is living in addiction or person working in drug services could access naloxone. I am aware that this is not just a domestic issue with regard to legislation but is also an EU issue. We would very much like to see Ireland leading the way here.
Yesterday, the Committee on Drugs Use published its interim report and it was very strong on the issue of naloxone. The Minister of State knows that the report is very much based upon the personal experience of drugs from the actual user's viewpoint. This is absolutely about saving lives. The change in the law is very small here but I would very much urge the Minister of State and the Department to act now, if possible.