A Thousand Ways to Say “No” to Naloxone

Every 5 minutes someone in America dies of an overdose. The single greatest barrier to increasing naloxone access is FDA’s designation of naloxone as prescription-only. For the first time, we highlight how prescription-only status cascades into myriad legal and practical barriers in ways that are unexpected. We ask FDA to remove generic naloxone’s prescription requirement for Harm Reduction programs, so that we may prevent overdose deaths more effectively. Remedy Alliance (For The People) operates the Opioid Safety and Naloxone Network (OSNN) Buyers Club, established in 2012. The Buyers Club is a collective of over 100 harm reduction programs who distribute naloxone directly to people who use drugs, their loved ones and community

Naloxone access is too complicated. A simplified future will save lives.

The current system is complicated and inefficient. Only harm reduction programs with physicians can obtain naloxone from manufacturers and distributors, or from health departments with standing orders. However, a simplified future will save lives. Non-profit supplies should be exempt from wholesale distributor regulations during a Public Health Emergency on overdose deaths. We can effectively remove the prescription requirement for programs and reduce reliance on imperfect standing orders. In face, FDA proposed doing exactly this last month, more broadly. Pending Drug Supply Chain Security Act regulations exempt distribution of emergency medications during a declared Public Health Emergency. If FDA enacted this proposed general rule for naloxone immediately, harm reduction programs could obtain naloxone without having to beg doctors to buy naloxone for them

Remedy Alliance For The People Annual Report 2023

This report covers August 2021 to July 2023, Year Zero and Year One of Remedy Alliance For The People. In our first year of operations as Remedy Alliance we sent 1,639,542 doses of generic injectable naloxone to 196 harm reduction projects in 44 US states, DC, and Puerto Rico, of which 206,371 doses were provided at no-cost to 138 under-resourced harm reduction projects; and we redistributed $180,000 in unrestricted funds to 20 under-funded harm reduction programs and mutual aid projects through our Community Support Initiative.“WE ENSURE HARM REDUCTION PROGRAMS HAVE SUSTAINABLE AND EQUITABLE ACCESS TO NALOXONE FOR DISTRIBUTION IN THEIR COMMUNITIES.

Overdose Prevention and Naloxone Prescription for Opioid Users in San Francisco

Opiate overdose is a significant cause of mortality among injection drug users (IDUs) in the United States (US). Opiate overdose can be reversed by administering naloxone, an opiate antagonist. Among IDUs, prevalence of witnessing overdose events is high, and the provision of take-home naloxone to IDUs can be an important intervention to reduce the number of overdose fatalities. The Drug Overdose Prevention and Education (DOPE) Project was the first naloxone prescription program (NPP) established in partnership with a county health department (San Francisco Department of Public Health), and is one of the longest running NPPs in the USA. From September 2003 to December 2009, 1,942 individuals were trained and prescribed naloxone through the DOPE Project, of whom 24% returned to receive a naloxone refill, and 11% reported using naloxone during an overdose event. Of 399 overdose events where naloxone was used, participants reported that 89% were reversed. In addition, 83% of participants who reported overdose reversal attributed the reversal to their administration of naloxone, and fewer than 1% reported serious adverse effects. Findings from the DOPE Project add to a growing body of research that suggests that IDUs at high risk of witnessing overdose events are willing to be trained on overdose response strategies and use take-home naloxone during overdose events to prevent deaths

Priorities for synthesis research in ecology and environmental science

ACKNOWLEDGMENTS We thank the National Science Foundation grant #1940692 for financial support for this workshop, and the National Center for Ecological Analysis and Synthesis (NCEAS) and its staff for logistical support.Peer reviewedPublisher PD

Priorities for synthesis research in ecology and environmental science

ACKNOWLEDGMENTS We thank the National Science Foundation grant #1940692 for financial support for this workshop, and the National Center for Ecological Analysis and Synthesis (NCEAS) and its staff for logistical support.Peer reviewedPublisher PD

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

The frugal housekeeper's kitchen companion, or, Guide to economical cookery : containing instructions in the art of cooking every kind of meats and vegetables, and in making plain and fancy cakes, puddings, pastry, confectionary, ice creams, jellies, and other delicacies : dedicated to those American housewives who are not ashamed of economy /

"An appendix or, supplement, Containing many valuable hints pertaining to Cookery, and the use which should be made of this art ...": p. [88]-96.Cf. Bitting, K.G. Gastronomic bib., p. 492.Lowenstein E. Amer. cookery (3rd ed.),Mode of access: Internet.White color illustrated, printed wrappers.ACQ: 35669; Janice B. Longone; Gift; 6/21/2001