Iran, Pakistan, Iraq, Qatar and the United Arab Emirates were the main countries that saw an increase in heroin use in 2015 and 2016 [1]. This increase was linked to the expanding of heroin trafficking from Afghanistan to these countries. Other countries such as Saudi Arabia, Jordan and Israel saw stabilization in heroin use, as stimulants are playing a larger role in these countries currently. On the other hand, some countries in East and South-East Asia saw a decline in heroin use in 2016 such as China, Indonesia, Thailand, the Republic of Korea and Hong Kong [1].
Pharmacists play a vital role in the implementation of THN strategies. Barriers that were identified to pharmacists providing naloxone education included time constraints, inadequate training, perceived lack of patient comprehension [36, 37], and lack of pharmacist prescribing privileges [38, 39]. A collaborative practice approach between prescribing physicians and pharmacists can be adopted to solve this issue by providing pharmacists with the necessary privileges to dispense naloxone through pre-authorized orders on the electronic health record system that they may activate. Stakeholders can play an important part in facilitating such policy reform efforts, and fighting community stigma and resistance [38, 39]. Targeted naloxone training in smaller chain pharmacies may be necessary as well [40], and structural changes in the level of insurance coverage to compensate pharmacists for brief interventions such as counseling on substance use, and naloxone administration training may be required as well [38].
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