Expanding Availability of the Opioid Overdose Rescue Drug Naloxone
Problem:
Opioids can suppress breathing to the point that the brain and body are deprived of oxygen. This can cause organ damage up to and including death.
Naloxone (also called “Narcan”) is an “antagonist” medication that can dislodge opioids from the receptor in the brain where they bind. However, the cost of naloxone has risen during the opioid epidemic, limiting access to the medication.
Solutions:
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Naloxone does not treat an underlying opioid addiction, but in an overdose will usually restore the individual’s breathing and allow more extensive medical care to be provided.
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Twenty-eight to thirty-eight states have implemented laws to allow non-physicians to legally administer naloxone, to allow the general public to access naloxone without a prescription, and to provide individuals who administer naloxone immunity from lawsuits.
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Programs training drug-using individuals to recognize overdoses and to administer naloxone currently operate in North America, Asia, Australia, and Europe.
Conclusion:
Expanding access to naloxone increases the medication’s availability to high-risk groups, increases opportunities to reverse otherwise fatal overdoses, and appears to have no public health downside.
Governmental initiatives such as negotiating bulk purchase discounts may be required to maintain broad access to naloxone.
Key Policy Evidence:
- In a 2014 study, states with naloxone access laws had 14% lower incidence of opioid-overdose mortality.
- U.S. states with laws expanding naloxone access are more likely to have opioid education and naloxone distribution programs operating in their counties, and this effect increases over time.
- There is no peer-reviewed evidence that naloxone access laws increase rates of prescription opioid misuse.
- U.S. states that allow pharmacists and physicians to provide naloxone to any requestor without a prescription and to write “third-party prescriptions” (e.g., for a parent to use on an opioid-addicted child) have higher rates of naloxone dispensed at community pharmacies.
- Laws to limit naloxone-associated liability have not affected civil litigation because no civil or criminal penalty has ever been applied to anyone involved in the prescription, distribution or administration of naloxone. Such laws may however help reduce irrational fears about lawsuits that deter some individuals from carrying naloxone.