Take-home naloxone programmes: history and perspectives

Naloxone is a life-saving medication, has a limited side effect profile, no abuse potential and is available relatively cheaply. Although naloxone has been used since the 1970s to treat opioid overdose, THN was only proposed in 1996. Now, THN programmes are established in Australia, Canada and at least 9 European countries, as well as being piloted in several lower- and middle-income countries. However, with the death toll from opioid overdose continuing to rise, there is a need for greater uptake of this essential medicine. Like other harm-reduction strategies, THN programmes have faced legal and logistical challenges from inception to endorsement by the WHO in 2014. Innovations in the field, such as new delivery routes and regulatory changes allowing THN provision over the counter, have helped shape the programme as it stands today. Much can be learned from the story of THN for forthcoming overdose prevention strategies.