Making a Drug <i>More</i> Available to Save Addicts' Lives

There's a growing movement to make the drug that can reverse overdoses widely available at pharmacies, police departments and schools.

Government associations have negotiated a discount on naloxone for public agencies.
From suburban Chicago to rural Vermont, the heroin epidemic has hit communities across the country. As federal policymakers grapple with ways to curb the number of fatal overdoses, state and local officials have started ramping up access to a lifesaving drug.

If administered properly and quickly, naloxone can resuscitate a person experiencing respiratory or central nervous system failure from an opioid overdose. In January, the National Association of Counties, the National Governors Association, the National League of Cities and the U.S. Conference of Mayors reached an agreement with Adapt Pharma to sell Narcan, the company’s nasal spray form of naloxone, to public agencies at a 40 percent discount.

Sallie Clark, the president of the National Association of Counties, says she’s been hearing from elected officials on every level about how bad the epidemic is. “We want to give people help, but we can’t do that if they’re not alive.” She hopes that the discount will remove a cost barrier preventing some localities from purchasing the drug.

When it came on the market in the 1970s, naloxone was primarily used by EMTs and ER doctors, but that’s quickly changed given the scope of the current epidemic. Several cities have authorized pharmacies to sell it without a prescription.

The Colorado Springs Police Department started requiring officers to carry the spray last October, and has seen at least one successful resuscitation as a result. “It truly is amazing to watch the drug work,” says Cmdr. Thor Eells. “You encounter someone virtually dead, spray them in the nose, and within seconds they are cussing and yelling at you.”

The opioid epidemic is unique because the lifesavers are often not doctors but pharmacists, school nurses or police officers. “We’re often the first responders in these situations,” says Eells. “It can take up to eight minutes for an ambulance to get to someone, and that’s a long time if you’re not breathing.” Nineteen states now have programs that equip cops with Narcan, and several states require school nurses to keep it stocked.

Delaware is one of those states. “School nurses have equipment for cardiac arrests and for diabetic shock. Why shouldn’t we have naloxone readily available?” asks Becky King, a Wilmington-area school nurse and a member of the executive committee of the National Association of School Nurses. “If I came across a kid passed out in a bathroom and didn’t have it on me, I would be sick.”

For many in public health, there’s a larger goal in making naloxone widely available. “We want to change the standard of care and reduce the stigma that naloxone carries,” says Jennifer Koziol, manager of the Prescription Drug Overdose Prevention Program in Rhode Island, another state that requires school nurses to keep the drug stocked. “We’re telling anyone with an opioid prescription to get it.”

That’s at odds with the views of those opposed to widespread naloxone distribution, who worry that it will discourage people from getting help for addiction if they know they can be saved from an overdose. But opioids are respiratory depressants whether they’re being used for pain or recreation, and King thinks the public deserves to be equipped to deal with that.

Eells agrees. “The numbers of people dying from overdose just keep rising,” he says. “As a cop, if we can even just help to stabilize those numbers, that will be a victory for me.” 

Mattie covers all things health for Governing.

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