- The Opioid Crisis
- Naloxone: A Matter Of Life & Death
Individuals Need To Carry Life-Saving Opioid OD Medication
THURSDAY, APRIL 5, 2018
Many paramedics and police officers carry an “Opioid Overdose Kit” as part of their standard-issue equipment. Now the U.S. Surgeon General is urging more Americans to acquire the same life-saving medication these first responders give overdose victims.
Naloxone can be the difference between life and death. The drug can reverse the effects of an opioid overdose. Surgeon General Jerome M. Adams announced today his recommendation “that more individuals, including family, friends and those who are personally at risk for an opioid overdose, keep the drug on hand.”
First Responders Often Too Late
Naloxone can be administered via a nasal spray or injection. The FDA-approved medication can suspend the effects of an overdose until more long-term medical care is provided. An opioid overdose will slow or completely stop a person’s breathing.
Unfortunately, emergency responders — if they are contacted at all — arrive too late to save an overdose victim’s life with the naloxone in their first responder OD kits.
Police officer training to administer Narcan, a nasal-spray form of Naloxone
“Each day we lose 115 Americans to an opioid overdose — that’s one person every 12.5 minutes,” said Dr. Adams. “It is time to make sure more people have access to this life-saving medication because 77 percent of opioid overdose deaths occur outside of a medical setting and more than half occur at home.”
No Prescription Required In Missouri
All 50 states have passed laws increasing access to naloxone. Missouri is among the states that allow an individual to request naloxone from a pharmacist without a prescription. The Missouri Department Health & Senior Services issued an Aug. 28, 2017, standing order authorizing any state-licensed pharmacist to dispense naloxone under the following circumstances:
- Persons who voluntarily request naloxone and are at risk of experiencing an opiate-related overdose, including but not limited to:
- Current illicit or non-medical opioid users or persons with a history of such use
- Persons with a history of opioid intoxication or overdose and/or recipients of emergency medical care for acute opioid poisoning
- Persons with a high dose opioid prescription (>50 morphine mg equivalents per day)
- Persons with an opioid prescription and known or suspected concurrent alcohol use
- Persons from opioid detoxification and mandatory abstinence programs
- Persons entering methadone maintenance treatment programs (for addiction or pain)
- Persons with opioid prescription and smoking/COPD or other respiratory illness or obstruction
- Persons with an opioid prescription who also suffer from renal dysfunction, hepatic disease, cardiac disease, HIV/AIDS
- Persons who may have difficulty accessing emergency medical services
- Persons enrolled in prescription lock-in programs
- Persons who voluntarily request naloxone and are the family member or friend of a person at risk of experiencing an opiate-related overdose.
- Persons who voluntarily request naloxone and are in the position to assist a person at risk of experiencing an opiate-related overdose.
- “To manage opioid addiction and prevent future overdoses, increased naloxone availability must occur in conjunction with expanded access to evidence-based treatment for opioid use disorder,” Surgeon General Adams said.
A Rare Advisory
Surgeon Generals rarely issue advisories, which are used to call attention to urgent public health issues. Today’s advisory by Dr. Adams was the first any Surgeon General has released since 2005 when then-Surgeon General Richard Carmona warned about the effects of women drinking alcohol while pregnant.
In his advisory today, Dr. Adams wrote about how crucial naloxone can be in treating an opioid overdose:
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.
The MO-HOPE Project — a partnership between the Missouri Department of Mental Health, Missouri Institute for Mental Health-University of Missouri St. Louis and NCADA — emphasizes that not every pharmacy will stock naloxone and suggests doing the following to obtain naloxone without a prescription:
1. Call to confirm the pharmacy stocks naloxone.
2. At the pharmacy, go to the prescription drop off window and ask to speak with a pharmacist about naloxone. While every pharmacy has their own protocol, the pharmacist must provide overdose education (overdose risk factors, how to recognize and respond to an overdose, and how to use naloxone) when dispensing naloxone.
3. The pharmacy may be able to bill your insurance, even without a prescription. While most insurances will cover at least a portion of the cost of naloxone, every insurance plan has different billing requirements. Your pharmacist can contact your insurance company to discuss any payment questions.