Amid opioid epidemic, some cities strain to afford overdose antidote

BALTIMORE — On a Baltimore street corner, public health workers hand out a life-saving overdose antidote to residents painfully familiar with the ravages of America’s opioid epidemic.

But the training wraps up quickly; all the naloxone inhalers are claimed within 20 minutes.

“We could’ve easily handed out hundreds of doses today. But we only had 24 kits. That goes fast,” said Kelleigh Eastman, a health department worker assisting the city’s bluntly dubbed “Don’t Die” anti-overdose campaign.

Cities like Baltimore are feeling the financial squeeze as they rely on naloxone to try to counteract rising overdose rates.

Some hard-hit communities across the country are struggling to pay for dosages even at reduced prices.

With more overdoses driven by synthetic opioids like fentanyl and carfentanil — so potent it’s used as an elephant tranquilizer — naloxone remains pricey enough that Baltimore’s health department is rationing supplies, stretching a dwindling stockpile of inhalers.

Last year, the city distributed more than 25,000 doses; that was up from about 19,000 in 2016.

“Every week, we count the doses we have left and make hard decisions about who will receive the medication and who will have to go without,” said Baltimore Health Commissioner Leana Wen, who issued the city’s innovative blanket prescription for the drug in 2015.

Numerous states have since passed laws — including bypassing prescription requirements and establishing community training programs — aimed at expanding use of the medication that restores a person’s breathing while temporarily blocking the brain’s opioid receptors.

Last week, U.S. Surgeon General Jerome Adams issued the office’s first national public health advisory in 13 years, calling on more Americans to start carrying naloxone and urging more federal funds be dedicated to increasing local antidote access.

“Costs should not and, in the near future, will not be a barrier to accessing naloxone for anyone in America,” Dr. Adams pledged.