The Advisory Council of the Misuse of Drugs (ACMD) has reviewed the evidence on the provision and availability of naloxone, a medicine which can temporarily reverse the effects of opioids and is used as an emergency treatment for people who overdose on these drugs. The findings of this review, and recommendations to optimise the use of naloxone are presented in this report.

The ACMD has reached the following conclusions:
• The importance of naloxone is apparent, with evidence showing an association between administration of naloxone and a reduction of opioid overdose-related deaths.
• There has been an increase in the number of people who have been administered naloxone over the last ten years. Although data from Scotland, Northern Ireland and Wales provides a clear overview of naloxone supply, there are challenges in understanding the level of naloxone supply in England, mainly because data are not being collected in a uniform fashion.
• More work is needed to widen the access to, and increase the uptake of, naloxone in community partnerships across the UK.
• Pharmacies are a key provider of take-home naloxone, and a UK agreement on the specific role of community pharmacies in distributing naloxone would promote collaborative working across the four nations.
• Further research is needed to consider the efficacy of peer-to-peer naloxone within a range of contexts.
• Evidence suggests that the supply of take-home naloxone on release from prison is fragmented across the UK, with only a small proportion of opioid-dependent prison leavers currently being provided with naloxone, even though studies find that a high percentage of these people would willingly accept take-home naloxone upon prison release.
• There are multiple police service pilot programmes across the UK which currently deliver intranasal naloxone (Nyxoid) as a more convenient method as opposed to intramuscular devices.
• Overall, it is apparent that a national joined-up approach to promote the delivery of take-home naloxone across different sectors is necessary, supported by rigorous data recording to measure progress. Interventions are needed across a range of different sectors, ranging from delivery of take-home naloxone within community pharmacies, promotion of peer-to-peer take-home naloxone programmes, police training, and increasing take-home naloxone supply amongst prison leave