Wider Availability of Naloxone in Australia 1999–2025: Across‐Sector Collaboration in Policy and Practice Development and Diffusion

BACKGROUND: Since the early 1990s there have been calls to make the opioid antagonist naloxone more widely available including through take-home naloxone (THN) programs where naloxone is made available to potential overdose witnesses such as people who use opioids, their peers and family members. A THN program was established in the Australian Capital Territory in 2012 with similar programs established in other Australian jurisdictions shortly thereafter. They were established in the context of an increasing trend in overdose deaths, but unlike parts of North America, no opioid crisis had been declared. OBJECTIVE: This paper tracks the development of THN in Australia from a small-scale program in one jurisdiction through to THN availability across the country at no charge. METHODS: Using a narrative approach, we describe the role of people who use drugs, clinicians, researchers, health officials and policy advocates in shaping THN policy and practice in Australia. RESULTS: Utilising partnership, piloting, evaluation and policy diffusion, a coalition of across-sector stakeholders, committed to evidence-based expansion of THN in Australia, led to widespread support that contributed to policy changes impacting a variety of settings, services and target groups. CONCLUSION: Although a public health opioid overdose emergency has not been declared in Australia, it has been possible to advocate for the establishment of THN and develop an evidence base and advocacy coalition that has led to a nationwide free naloxone program and empowering those most at risk of opioid overdose-related harms.