Lynn Ruane (Independent) | Oireachtas source

I move amendment No. 2:

In page 11, line 23, after “ailments,” to insert “or in response to the need for urgent or life-saving medicinal care,”

The amendment relates to ailments and seeks to insert “or in response to the need for urgent or life-saving medicinal care”. We have legislation that was amended in the past to allow for the likes of access to EpiPens. There is legislation that allows for lifesaving treatment in that regard but it does not currently involve access to naloxone. The pharmacist has to be the one who provides naloxone to somebody. An individual cannot run in to try to access naloxone and bring it back out to somebody. A person is not able to go to his or her local pharmacy, say that he or she has a situation whereby his or her son, daughter or partner is an active drug user, and that he or she would like to have naloxone, especially nasal naloxone, which is much easier and more convenient to use. There are appropriate online resources to show how someone can use naloxone. Training should not be a barrier to that. For people who are not aware of nasal naloxone, I suffer from migraines and twice a year I will have to get a very specific nasal pump up the nose. That is what treats the migraine. It is no different from naloxone treatment, which is also a nasal spray. Somebody's health cannot be negatively impacted by giving him or her naloxone, even if it turns out that the person was not actually in an active overdose. No harm will be done if the signs of overdose are read incorrectly.

The amendment seeks to provide that prescription medicine should be provided by a pharmacist or other suitably qualified prescriber in circumstances where there is a need for urgent or lifesaving medical care. At present, the urgent piece is covered if the pharmacist is able to respond in the moment.The lifesaving piece is being able to have access to that lifesaving drug over the counter or in your home, and that a pharmacist can make that call and give it to you. It is not a dangerous drug and will not harm anyone. Even if you are given five, six or seven doses of naloxone, you are not going to be harmed. It is not something that can have an adverse effect on somebody if they happen to be close to an overdose. This is specific to that piece.

The European Drug Report 2024 shows that Ireland had 322 drug-induced deaths in 2020 and 97 deaths per million people compared with the EU average of 22.5. This statistic places Ireland at the very top of the EU table for drug deaths, with more than four times the average number of fatalities. Opioids, namely, methadone, street or prescribed, and-or heroin were involved in 87% of the deaths recorded. Naloxone is only an antagonist for an opioid. When we think of that 87% and consider that naloxone is an antagonist for opioids, which are causing the most deaths, making it as accessible and freely available as possible could go some way to ensuring some of those deaths do not happen. There will be some cases where someone uses and dies alone with no one there to help. You are never going to be able to bring yourself out of an overdose because, at that stage, you have already slipped off into a state of sleep. However, for those who are not alone, who are found by a loved one, who are on the streets or in an estate or whatever it may be, being able to access naloxone is important.

I know this legislation relates to pharmacists but it is also important in the context of accessing medicines within the prison system. What happens in the prison system is that people are trained in overdose prevention and are trained in responding to an overdose among their peers by the Irish Red Cross and so on. Men in the prisons are communicating to me that what happens when someone overdoses is there is a little fear about alerting the people who need to be alerted. They are worried that, if the person is not in an overdose, they may have drawn attention to something for which someone is going to be punished. Are they going to put on a P19? Are they going to have certain enhancements revoked? Will there be a raid on the wing? People start to then negotiate in a situation where there is a potential need for a lifesaving intervention because they are concerned whether the person is in an overdose and if raising the alarm will bring unwarranted attention. We do not want that ever to happen. We have men in the prison trained in naloxone and could have more such men, and if we had that more freely available, the men have suggested having something like a smash box at the end of the wing so that they themselves could make sure they have brought a person around from an overdose and are not unnecessarily risking life on the off-chance that a person might not be overdosing.

I know that is kind of a side point to the consideration of the role of the pharmacist but it is about the wider point of naloxone not being a prescription-only medication for the individual who uses drugs, whose life might be chaotic and who may not remember to go to a pharmacy to get a top-up of the drug. It should be an over-the-counter medicine and people should be allowed to have it in their homes, shops and wherever else it may be. Allowing pharmacists to make the call in that regard could go a long way towards making it happen.