Surgeon general household naloxone access vital to opioid crisis solution – washington times electricity japan


Naloxone has taken on almost mythic proportions in the effort to combat opioids. While it can’t address the heart of an epidemic with roots in modern medical practice and rural poverty, it gives people with an addiction the chance to survive an overdose.

Trained professionals use an injectable form of naloxone. Two products are available for general use: Narcan nasal spray and an auto-injector known by the name Evzio, which talks to users and explains how to press it against the thigh of someone who has overdosed.

U.S. Surgeon General Jerome Adams recently advised family members and friends of people at risk of overdosing, or those who are abusing opioids themselves, to carry one of the devices and understand how to use it. Three-quarters of overdoses occur outside of a medical setting, and more than half occur at home.

“The surgeon general is spot on. This is exactly the thing to do,” said Dr. Dan Ciccarone, a professor at the University of California, San Francisco, who studies the opioids issue. “The biggest issue is not whether naloxone works. It’s access — timely access to treat an overdose victim. What’s the best access? Household access.”

The Health and Human Services Department said the advisory is paying off. The number of prescription-based retail sales jumped from 9,150 in the week before the announcement to about 9,600 in the week of and to 11,650 in the first full week after the advisory, the department said.

Starting in 2015, it enacted a law that lets people purchase naloxone without seeing a doctor first, and a Good Samaritan law that provides legal immunity to those who administer naloxone to themselves or others after illegal drug use, and then seek help.

Baltimore’s health department also distributes naloxone through churches and nonprofit groups, but limited government funding hasn’t caught up with the cost of the drug, Dr. Wen said, even at a discounted rate of $75 for a two-dose kit of Narcan for government purchasers.

“Fortunately, the majority of Americans see substance use disorder as a public health problem and are supportive of equipping first responders and community members with an emergency treatment for opioid overdose,” said Health and Human Services Department spokeswoman Kate Migliaccio.

Gary Mendell, founder and CEO of Shatterproof, a nonprofit that seeks to destigmatize opioid addiction and recovery, said the trends are heading in the right direction but addiction still isn’t treated with same type of urgency as other health scares.

“If Zika were spreading around this country, and we had a vaccine that we knew if someone exhibits certain symptoms, they would take that vaccine they would live, and where alternatively, if they didn’t, they would die, the federal government would ship it to every household in the United States,” Mr. Mendell said. “Here, that’s not happening.”

A study released in March by economists at the University of Virginia and the University of Wisconsin looked at states that increased access to naloxone versus those that did not. It found that broadening access “led to more opioid-related ER visits and more opioid-related theft, with no reduction in opioid-related mortality.”

A landmark Massachusetts study from 2012 found that giving naloxone to bystanders decreased overdose deaths. A study published last year by the National Bureau of Economic Research said states that adopted naloxone access laws showed a 9 percent to 11 percent drop in opioid-related deaths.

Kenneth Coontz, chief of police in Mansfield, said a 44 percent drop in overdose deaths from 2016 to 2017 is likely attributable to that same combination of naloxone and early intervention, though numbers are creeping up this year as powerful fentanyl enters the market.

“With any social crisis, you’re always going to get people who have that thought: ‘This is now a safety mechanism. I have a buddy who has Narcan,’” she said. “I do think, though, it’s not as simple as that, and that’s a very small group, frankly. I don’t think this is giving people permission [to use].”

Coordinators in the Huntington area say fewer people in their communities question the value of naloxone today than they did several years ago, in part because of the sheer number of users who are dying. Everyone knows someone who has been affected by the crisis, so they are more likely to see the drug as a way to help folks who aren’t bad people, even if they have bad problems.