DOC: NAXOLONE NO OPIOID SOLUTION
Drug viewed as more of a Band-Aid
The surgeon general recommended yesterday that more Americans carry the opioid overdose reversal agent naloxone — but local doctors say it is more of a Band-Aid than a fix and the medication’s skyrocketing price could limit access to the general public.
“This can’t be viewed as the end or the solution to all this,” said Dr. Scott Wiener, director of Brigham and Women’s Hospital’s Comprehensive Opioid Response and Education Program. “There are so many interventions that need to happen. Safe prescribing, increasing access to practitioners — this is a foundation and needs to be there, but it can’t be the only measure.” Surgeon General Dr. Jerome Adams issued an advisory yesterday, calling for people to carry naloxone, more commonly known as Narcan.
“For patients currently taking high doses of opioids as prescribed for pain, individuals misusing prescription opioids, individuals using illicit opioids such as heroin or fentanyl, health care practitioners, family and friends of people who have an opioid use disorder, and community members who come into contact with people at risk for opioid overdose, knowing how to use naloxone and keeping it within reach can save a life,” Adams said.
Naloxone has been largely credited for the 8 percent drop in fatal overdoses in the Bay State last year.
Boston EMS numbers reflect a significant increase in Narcan use over the years.
The medication was used a total of 11,134 times for the first three quarters of 2015, compared to 13,785 times for the first three quarters of 2017. Fourth-quarter data is not yet available for last year.
And though Wiener said he would get behind Adams’ recommendation, there are some important caveats, including the prohibitive price of the medication.
California-based pharma company Amphastar charges $40 for its version of the medication, which is a 95 percent increase since 2014.
Evzio, a newer and more userfriendly version, is up 500 percent over two years and costs $4,500.
“This is inexcusable in the setting of a public health crisis,” said Dr. Sarah E. Wakeman, medical director of the Massachusetts General Hospital Substance Use Disorder Initiative. “To make it truly feasible for more people to carry naloxone, this price-gouging must be addressed.”
Despite price barriers, doctors encourage those who know people with substance use disorders to keep it close by if possible.
Dr. Traci Green, deputy director of injury prevention at Boston Medical Center — who carries naloxone in her backpack — said friends and family of people with substance use disorder can make the biggest difference by having the medication on hand.
“Keep it in the drawer in the kitchen, the back of the medicine cabinet,” Green said. “It’s a critical thing that anyone can do.”