Experts urge better opioid rescue drug access to save lives
Jessie Blanchard started small nearly five years ago, just trying to get enough of the rescue drug naloxone that reverses opioid overdoses to keep her daughter from dying from an overdose.
She pleaded with colleagues at the college where she’s an adjunct teacher in Albany, Georgia, to use their prescription benefits to get two doses every six months.
Now she loads her Jeep every week and heads out with a few other volunteers to bring the antidote — commonly known by its brand name Narcan — to hundreds of others in the town of 70,000.
At parking lots and intersections she also supplies clean needles, fentanyl test strips and a nonjudgmental sounding board — an effort now partly funded by a state government grant. At least nine times in December alone, Blanchard said, rescue drugs she provided were used to reverse overdoses.
“I’ve got story-afterstory, story-after-story of people coming up to me,” said Blanchard, a nurse whose organization is called 229 Safer Living Access, a reference to the Albany area code the group’s work covers. “They say, ‘Miss Jessie, they had to Narcan me the other day and I’d have died if it wasn’t for you.’”
Naloxone, available as a nasal spray and in an injectable form, is a key tool in the battle against a nationwide overdose crisis linked to the deaths of more than 100,000 people annually in the U.S. State and federal policy changes have removed some major obstacles to getting it into the hands of police, firefighters, people who use drugs and their loved ones. But it’s still often frustratingly inaccessible in the moments when overdoses happen.
Stephen Murray, an overdose survivor and former paramedic who researches overdoses at Boston Medical Center, is
so committed to naloxone access that he proclaims it on his personalized license plate: NARCAN.
“My vision for it is to be in every 24-hour gas station in the state, free or 25 cents a dose,” he said. “It’ll be between the Tylenol and the condoms. … It has to be just as easy as buying heroin, basically.”
There’s more naloxone than ever thanks to federal and state policies, and
groups like Blanchard’s that distribute it in their communities. It’s available free in old newspaper vending boxes in Michigan, which now hold naloxone kits, and in a vending machine in Philadelphia. One group, NEXT Distro, mails it nationwide for free. But Murray’s vision is not close to being realized in most places.
An influx of money is on the way, intended to help deal with the national overdose crisis that killed 107,000 people in 2021 — the highest tally ever — most involving fentanyl and other powerful illicit synthetic opioids.
Drug makers, distribution companies and pharmacies have settled lawsuits with state and local governments, and the first funding totaling more than $50 billion is going out. Most of it must be used to address the opioid epidemic, though exactly how will be up to governments receiving the money. Some settlements are being delivered partly in doses of naloxone.
In a 2021 report, public health experts convened by the Johns Hopkins Bloomberg School of Public Health listed expanding naloxone access as the first strategy for using settlement funds, noting that 40% of overdose deaths happen when someone else is present and possibly able to administer the life-saving drug.
As with other harmreduction strategies, there’s been pushback from those who believe making naloxone available enables drug use. But Jeff Breedlove, policy chief for the Georgia Council for Recovery, said he no longer sees that as much of an issue.
Instead, he said, funding and distribution programs remain spotty because they don’t have enough support from government and private groups such as chambers of commerce. “Until they treat it like an epidemic,” Breedlove said, “we will continue to have more and more funerals.”
Since 2016, the federal government has allowed and encouraged federal funds to be used to buy naloxone.
Officials in every state have given standing orders to pharmacies allowing people to buy it, even without prescriptions.
That’s a major factor for the massive increase in how much has been distributed through retail pharmacies. A report by the American Medical Association and IQVIA Institute for Human Data Science found there were just over 1,000 orders filled in 2012. By 2021, it was nearly 1.2 million.
But not all pharmacies carry it. And it comes at a cost: For those without insurance coverage, it can be around $50 for two doses.
The U.S. Food and Drug Administration is considering allowing some forms of naloxone to be sold over-the-counter without a prescription, a move that could lower the cost.