Lake County, Illinois, police deputies were called to assist a 27-year-old woman overdosing on heroin; she was unresponsive and no longer breathing on her own. According to patch.com, Deputy Kevin Crowley administered two doses of naloxone, which he obtained through his department’s participation in the Lake County Opioid Initiative, and the woman began breathing on her own. She was conscious and alert by the time she reached nearby Good Shepard Hospital. This marked the 49th time a life was saved by naloxone in Lake County.
When describing naloxone’s effectiveness, Madison Police Officer Carrie Hemming told WISC-TV, “Whenever you have somebody who is not breathing you have four to six minutes before their brain is either damaged or completely beyond help.” But, because of naloxone’s quick response time, the subject is cognizant within a matter of minutes. “When you really stop and think about it, a person who was going to be dead and they received a drug and now they are talking to you,” Hemming said.
Naloxone’s ability to almost instantly reverse an overdose causes some to hail it as a miracle drug. Naloxone’s safety, ease of injection and increasing availability indicate emerging possibilities for reversing the trend of opioid-related deaths.
Naloxone is an opioid antagonist, meaning it works by blocking the brain’s ability to be affected by an opioid, reversing the drug’s effects in a matter of minutes. Overdose victims can tolerate multiple doses, which typically last around 20 minutes.
Caregivers administer naloxone in one of two ways. The first is by injecting a liquid version of the medicine into a vein or muscle via a pre-filled automatic device, much like an EpiPen. The device, called EVZIO, is a self-contained injector that provides a one-time supply of the drug. EVZIO even features audible voice instructions on administering the drug, so while formal training is recommended, it’s not needed. The drug can also be administered as a nasal spray. Simply spray the drug into one nostril of the overdosing person. If needed, an additional spray can be used in the other nostril.
Naloxone is extremely safe for both the opioid addict and the general public. Because it works only if there are opioids present in a person’s system, there is no harm if the drug is taken by someone who isn’t overdosing. Users do not feel a high, and it is not addictive. Naloxone is safe for all adults and has even been used on infants who are born to mothers with opiates in their system.
With opioid addiction topping most cities’ causes of death, programs training police and medical personnel are popping up across the nation.
Police precincts in Massachusetts reported the reversal of over 400 deaths in October of 2015. New York reports 390 successful reversals; Madison, Wisconsin, reports saving one person a week; and the state of Ohio reports that more than 12,000 overdoses were reversed by naloxone. These numbers don’t just speak to the viability of naloxone to work. They also show the need to increase the drug’s availability to the general public.
Out of the 50 states, 42 implemented a type of naloxone law in 2015. In October of 2015, President Obama voiced his support for an expanded, nationwide naloxone program that included allowing more healthcare providers to prescribe naloxone, increasing training options for doctors to learn more about opioid addiction, and providing over 300,000 police members with opioid resurrection kits.
Like most prescription medications, naloxone is obtained through a licensed medical practitioner. However, unlike most prescriptions, naloxone isn’t prescribed to the people who actually need it. Because the drug is used to stop an opiate overdose as it’s happening, it would be extremely difficult for the person who is overdosing to use the drug. Because of the drug’s ease of use and relative safety, prescriptions are encouraged for individuals who believe they could do some good with it. This includes friends and family members of opioid users or those who live in an area where opioid use is rampant.
There is an option to purchase naloxone without a prescription, but so far it is limited to only 16 states — Arkansas, California, Indiana, Massachusetts, Minnesota, Mississippi, Montana, New Jersey, North Dakota, Pennsylvania, South Carolina, Tennessee, Utah, Wisconsin, and now New York.
CVS Pharmacy is leading the way with both selling naloxone without a prescription and funding further research to prove is efficacy. The pharmacy chain hopes to expand prescription-free naloxone to other states through its research efforts.
Update: CVS announced it has now added Ohio, a state with one of the highest overdose-related death rates in the country, to the list of states selling naloxone without a prescription, increasing the number of states selling the drug over the counter to 17.