 Can you explain us what naloxone is? Naloxone is a medication that has been used for many decades. It is used as an emergency antidote to reverse the symptoms of an opioid overdose. Heroin goes to a center called the Pons where the respiratory center of the brain is. Heroin works at that center and depresses it. And then in overdose, finally turns it off so that the brain is no longer instructing the lungs to breathe. Overdose is a leading cause of death among people who use drugs. In countries where that's recorded well, we see that overdose is a leading cause of death among youth. In New York City, there are actually like far more deaths from opioid overdose every year than there are like murders and suicides. The most important thing to do for overdose is naloxone. The medication has got to be the backbone of any intervention once the overdose happens. There are two types of kits that are generally used in the United States. One comes in either a one milliliter vial like this or a 10 milliliter vial which looks similar but bigger. And that one is administered with the intramuscular syringe. The other kind is for a nasal formulation which can be squirted up the nose. So this is the naloxone. This is a intramuscular syringe and you only need one milliliter. And that is ready for injection into the arms, the thighs, the buttocks, anywhere there is muscle and fat tissue. The second one is liquid that's in a glass canister and it comes in two parts. One is the syringe and the naloxone and one is what's called a nasal applicator. So you take that out, you open this big yellow part, you screw it on, you take this top off, you take that top off, put it in. And it's ready to go to the nose. Five people myself. The first one was a woman who had come and her boyfriend had come to our outreach a number of times. She was running through one time and she heard us talking about overdose and naloxone and she mentioned to her boyfriend one day they came to one of our sites and got some syringes and other equipment they went to inject and she went out. He was horrified. She was unconscious and she was turning blue and he didn't want to bring her to the hospital for fear of the police and being charged with murder which happens in Chicago. He drove back to our site remembering what she had said about overdose. She was crying, please help. We went to the car. She looked dead as dead as anyone can look. The first thing you do is you check to see that the person doesn't respond to painful stimulation such as knuckles on the lips or the chest. She did not and so I drew up a cc of naloxone and injected it into her shoulder. The chair back in the passenger seat and I breathed for her maybe three or four times and she woke up and it sounded like this. You know just like a baby being born or someone splashing you with cold water. And then I spent the next half hour with her and her boyfriend teaching them about overdose and how to help each other should it happen again. And it did. It happened a few times with them and they revived each other. They're still alive and happy and healthy today. Relatively new practice that has proven to be quite effective is the distribution of naloxone directly to people who use drugs previously. It was available and it's been available for a long time for hospital based uses. But what we see is that most of the time when a drug overdose occurs people are not necessarily near the place where the naloxone is available. Oftentimes there's reluctance to call for medical help because people are afraid of police interference. What we can do by giving out naloxone to the communities, the families, the friends of people who use drugs is to make sure that the naloxone is where it needs to be when overdoses occur. A very brief kind of training, you know, 10 minutes on a street corner and that can be enough to like give someone the skills to be able to save someone's life in that situation. There are several medical precedents for putting medical interventions into people's hands in case of accidental poisonings. Like giving people an epi-pen if they're allergic to be bites or most people when they're diabetic are prescribed glucagon which is a medication that can help them if they have an insulin reaction. So there are these precedents and both glucagon and epinephrine have far more potential for harm than naloxone does. It has no potential for abuse. It has one action only. It blocks the opiate receptor. In someone who is not dependent on opiates, you will feel nothing. It's like sugar water. You could pump a cup of it into a newborn baby and the baby would feel nothing. This is an incredibly cost-effective intervention. You know, naloxone costs a dollar a vial. So it's not an expensive thing. It just needs to become part of the way we provide services. The international research as well as the research conducted in the United States I think shows a very convincing case for the continued support of the naloxone programs. In most programs for every 10 people that you train and give naloxone to, one person will use that naloxone to reverse an overdose. So when you talk about training 10,000 people, you're talking about saving potentially hundreds of lives. In Khorogh, in Tajikistan, local NGO began to distribute naloxone of both among communities and people who use drugs as well as to emergency services. And you can see really even within the first year of their work that they've reduced overdose death almost to zero. Whereas previously I think they were having around 200 deaths a year. They have started a number of pilot overdose prevention programs in Russia which work very successfully and which have shown their efficiency during the last I think two years. Naloxone became probably one of the most popular harm reduction products in the cities. Drug users come first for naloxone and then to get other services such as syringes or drug testing or whatever. We have across the board had very positive feedback from, especially from parents of children who are using drugs where they feel empowered for the first time to have something where they can save their children's lives. Heroin addicts know that they're useless, that they're worthless, that most people think they'd be better off dead. They know that. They get told that by all sorts of people all the time and they begin to believe it. When we give someone a bottle of naloxone we are telling them with actions so much better than words. Here it matters whether you live or die.