At this point the evidence supporting naloxone distribution is primarily anecdotal, although promising. Although the distribution of naloxone holds promise for further reducing heroin overdose mortality, problems remain. Naloxone alone may be insufficient in some cases to revive the victim, and cardiopulmonary resuscitation (CPR), especially rescue breathing, may also be needed. A second dose of naloxone might be necessary. Complications following resuscitation from overdose may infrequently need in-hospital care. Mortality from injecting without anyone else present will be unaffected by take-home naloxone. Take-home naloxone should be studied in a rigorous scientific manner.

This study describes overdose experiences of heroin users, both the overdoses they themselves experienced, as well as those that they witnessed. A structured interview was performed with 101 current heroin users in Albuquerque, New Mexico from January 7, 2002 to February 26, 2002. Heroin-related overdoses were found to be common in this sample of heroin users. Three or more persons were reported to be present during 80 of the 95 most recently witnessed overdoses. An ambulance was called in only 42 of the 95 witnessed overdoses. Seventy-five percent of the respondents who witnessed an overdose stated concern over police involvement was an important reason for delay or absence of a 911 call for help. One hundred of the 101 respondents reported willingness, if trained, to use rescue breathing and to inject naloxone to aid an overdose victim. New methods need to be found to reduce heroin overdose death. Scientific studies are needed on the efficacy of take-home naloxone.

Summary Currently, quantum key distribution (QKD) using continuous variable (CV) technology has only been demonstrated over short‐range terrestrial links. Here, we attempt to answer whether CV‐QKD over the much longer satellite‐to‐Earth channel is feasible. To this end, we first review the concepts and technologies that will enable CV‐QKD over the satellite‐to‐Earth channels. We then consider, in the infinite key limit, the simplest‐to‐deploy QKD protocols, the coherent state (CS) QKD protocol with homodyne detection and the CS‐QKD protocol with heterodyne detection. We then focus on the CS‐QKD protocol with heterodyne detection in the pragmatic setting of finite keys, where complete security against general attacks is known. We pay particular attention to the relevant noise terms in the satellite‐to‐Earth channel and their impact on the secret key rates. In system set‐ups where diffraction dominates losses, we find that the main components of the total excess noise are the intensity fluctuations due to scintillation, and the time‐of‐arrival fluctuations between signal and local oscillator. We conclude that for a wide range of pragmatic system models, CS‐QKD with information‐theoretic security in the satellite‐to‐Earth channel is feasible.

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