Naloxone Can Save Lives, So Why Isn’t It More Readily Available?

With more than 2 million Americans being affected by prescription opioid misuse each year and annual opioid-related fatality numbers extending to tens of thousands, it’s no wonder that there’s an increased urgency to develop new solutions to curb this nationwide epidemic. But while there’s already a treatment on the market that can reverse opioid overdoses, whether it’s consistently accessible or not is a completely different story — and this could make all the difference between life and death for countless individuals.

The U.S. holds over 45% of the global pharmaceutical market at present, and opioid makers have — until recently, at least — had the opportunity to make a killing (both literally and figuratively). Now, those manufacturers and distributors are being held legally responsible, but the damage has really already been done. Approximately 21% to 29% of patients who are prescribed opioids for chronic pain misuse those prescriptions, with up to 12% of those patients going on to develop an opioid use disorder. Each day, more than 130 people in the U.S. die as a result of opioid use, according to the National Institute on Drug Abuse. And despite the fact that driving while under the influence is a legal consequence faced by many (in some states, like Michigan, underage drivers can even be charged with zero tolerance OWIs), a recent study even found that Americans have a greater chance of dying due to an opioid overdose than they have from dying in a car crash.

In other words, something needs to change. Certainly, there are actions being taken in an effort to reverse this dangerous opioid trend. The development of naloxone, for example, could have a significant impact on opioid deaths in America — that is, if the general public can gain access to it. This safe, effective, and non-addictive drug is used to counteract the respiratory arrest that comes with an opioid overdose. In other words, it’s used as an antidote. Available as either an injectable or a nasal spray, naloxone can immediately relieve the symptoms that can lead to opioid-related fatalities without having any other effects or long-term consequences.

The problem? Naloxone may be available only via prescription in some states — and it’s expensive to get. Some state laws have already expanded access to the drug with no prescription necessary, but even then, it may not be accessible. One study found that four in five pharmacies and drugstores, located in the 10 states with the highest opioid overdose death rates in 2016, stocked naloxone. Roughly 41 states allow pharmacists to dispense naloxone sans prescription, but American pharmacies don’t always keep it in stock. Moreover, half of the pharmacists surveyed in this study believed they could dispense the drug only to adults — which isn’t the case and could put young people at risk. And while police officers and first responders often have naloxone on-hand, many of the friends and family members of people struggling with opioid addiction don’t have this antidote within reach when it’s needed.

The FDA recently made a big push for the development of over-the-counter versions of naloxone and has encouraged drug makers to enter the over-the-counter market with the release of labeling requirements. They even developed a model Drug Facts Label in order to make it easier for these companies to gain approval and get their products on the market, which is a first for the agency.

But even being given the green light from the FDA may not be enough to ensure this medication is readily available. While it’s possible to obtain the drug, many ordinary people don’t know to get it — or how to use it. There are also those who believe that people struggling with addiction will use naloxone availability as a “safety net” to continue using drugs, which has more to do with the pervasive stigma surrounding addiction than anything else. There’s no scientific evidence to prove that naloxone encourages opioid use, of course. But between misinformation surrounding substance abuse, inconsistent availability, and increasing prices of naloxone medications, it’s a wonder that anyone is able to receive the help they need.

Ultimately, the fact that this product even exists is a literal lifesaver. But more progress needs to be made to ensure that the Americans who need
it most are able to actually get heir hands on it.