Need the Drug That Reverses Heroin Overdoses? Maryland Will Sell It Over the Counter

Maryland residents may now buy a lifesaving nasal spray used to reverse a heroin overdose without a prescription.

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By Elisha Sauers

Maryland residents may now buy a lifesaving nasal spray used to reverse a heroin overdose without a prescription.

A decision announced Monday will allow all licensed pharmacists to dispense naloxone, commonly known as Narcan, to anyone trained through the Maryland Overdose Response Program. Dr. Howard Haft, deputy secretary of health and mental hygiene, issued the statewide order using authority granted under a new law.

Public health officials said expanding access to naloxone is a critical part of the state's strategy to reduce heroin overdose deaths, which increased 60 percent in Maryland between 2010 and 2014. As of November, Anne Arundel County police responded to 313 heroin overdoses this year, almost equal to the number of overdoses in 2014, department officials said.

Forty-one people have died of heroin overdoses this year, police said.

Dr. David Rose, Anne Arundel County deputy health officer, said the naloxone order helps the overall plan to reduce heroin overdose deaths.

"We're just very happy that the state has taken this step," he said.

Under the prior policy, either a physician or nurse practitioner had to lead the naloxone training sessions because of the need for prescriptions. With the prescribing barrier removed, the agency has more flexibility in terms of who can teach the workshops, Rose said.

Since January, the county Department of Health has offered free training and certification to citizens on administering naloxone. The two-hour workshops are for family, friends and associates of addicts, as well as social workers and staff who work at halfway houses.

The instructions are straightforward: First, try to wake up the victim, then call 911. While waiting for emergency responders, start a sternal rub. After giving the patient a few rescue breaths, apply the nasal spray. Half of the vial goes into each nostril. Depending on the severity of the overdose, the patient may need several more doses before he is revived.

This year marked the expansion of naloxone training to average county residents. Months earlier, in May 2014, county health officials began offering the classes to patients at local methadone clinics and inmates at the Ordnance Road Correctional Facility.

County and city police officers began carrying Narcan last year so they could intervene in overdoses.

So far this year the county health department has trained 441 people to use the antidote, which can also reverse overdoses of prescription pain medicines, such as oxycodone and hydrocodone.

As health officials try to educate the general public on how to deal with overdoses, they're also fighting misinformation. Often individuals will try to help an overdose victim using street remedies, such as putting ice on the groin, injecting the victim with milk and using a lighter to burn his fingers and feet. These techniques could cause a patient more harm and waste precious minutes if the person is dying.

To assist the drug stores with naloxone dispensing under the standing order, state officials are faxing guidelines to pharmacists. In the county, 22 pharmacies from Edgewater to Brooklyn Park stock naloxone.

Pharmacists immediately may begin dispensing to anyone with an Overdose Response Program certificate. Certificate holders still must pay for the naloxone through their insurance or out of pocket.

But the fact that administrators don't need a prescription in their own names to get the nasal spray now may remove some stigma from the process. Officials hope it will encourage more friends and relatives of heroin users to go to the workshops.

"It's hopeful that it will result in having less fear and less trepidation about going to the training," Rose said.

(c)2015 The Capital (Annapolis, Md.)

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Caroline Cournoyer is GOVERNING's senior web editor.
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