Affordable opioid antidote running low
An affordable antidote for opioid overdoses has become more difficult to obtain amid a fatal epidemic, in what advocates have called a “perfect storm” with deadly consequences.
After a manufacturing issue halted Pfizer’s production of the single-dose injectable naloxone in April, groups that distribute a significant amount of the lifesaving medicine say they are facing an unprecedented obstacle to reverse drug overdoses as they reach an all-time high.
Organizers say the insufficient supply has been felt unequally across the country. Pfizer, which offers naloxone at a discount to a national buyer’s club made up of harm-prevention programs, said it may take until February before it can meet demand again.
The community programs that rely on the buyer’s club have resorted to seeking donations to buy naloxone at market price or looking for supply from places where the antidote is sitting on shelves and expiring.
A dose of generic naloxone typically costs upward of $20 wholesale. Buying the same quantity of the drug from other manufacturers isn’t attainable, activists told The Washington Post.
Without supply, organizations such as Utah Naloxone must weigh which facilities, including libraries and treatment centers, it will no longer stock, said Jennifer Plumb, the group’s founder and medical director.
“Who do you stop supplying?” Plumb said. “Who do you stop prioritizing? Who do you stop making sure has naloxone?”
Utah Naloxone has distributed the antidote for six years, recording more than 5,600 overdoses that were reversed. Plumb, who is also an associate professor of pediatrics at the University of Utah, estimated that without the lifesaving naloxone on hand, hundreds of reversals every year would end in death.
“It makes me a little teary,” Plumb said, wiping her eye. “It’s that real for me. It’s that horrifying.”
Pfizer declined to provide additional information about what led to the manufacturing issue but disclosed it is unrelated to its production of the coronavirus vaccine it developed with German partner BioNTech. Drug policy outlet Filter was the first to report on the supply disruption.
While the Food and Drug Administration has not added naloxone to its shortage list, the Opioid Safety and Supply Network Buyer’s Club — the national consortium of more than 100 harm-reduction programs that have provided millions of doses since 2012 to communities at a reduced price — reports the unprecedented scarcity is expected to have deadly consequences.
Maya Doe-Simkins, an organizer for the buyer’s club, estimated that the 250,000-dose backorder so far could result in at least 11,000 overdose deaths.
The past year has already topped records for drug overdoses, more than 93,000, with opioids and the deadly synthetic opioid fentanyl driving the death toll, according to preliminary data from the Centers for Disease Control and Prevention. Overdose deaths involving opioids surpassed 69,000 in 2020.
Activists say those most likely to suffer from shortages are programs with limited funding or in communities without adequate laws and infrastructure to distribute naloxone.
In some areas, especially in the Midwest, South and Appalachian regions, programs operate under the radar, without authorities’ approval, said Eliza Wheeler, another buyer’s club organizer.
Harm reduction, or efforts to minimize the harms of substance use, has faced backlash from critics who argue providing clean needles, fentanyl testing strips and naloxone enables drug use. Recent studies show such approaches save lives.