A Cure Withheld

BY RACHEL BUTLER

In 2012, US health care providers wrote 259 million prescriptions for opioid painkillers, enough to give a bottle of pills to every adult in the country, and that number is on the rise. Prescription medications now kill more people than cocaine and heroin combined. Illegal opioids like heroin are also cheaper and more readily available than ever before—a packet of heroin sells for just six or eight dollars. The United States is currently facing an epidemic of opioid overdoses: between 1999 and 2010, the number of drug-poisoning deaths in the country involving opioid painkillers grew from 4,300 to almost 17,000. Despite these rising numbers, pharmaceutical companies approve new, ever-stronger opioid painkillers every year, and doctors continue to prescribe them freely and in high doses.

Naloxone, a drug that can be administered as a nasal spray to halt an overdose, is a potential solution to this problem, and yet it is much harder to obtain than the opioids themselves. Often referred to by its brand name Narcan, naloxone can rapidly reverse an overdose on opioids of any type. Approved by the FDA in 1971, it does not produce a high, has few side effects, and cannot cause an overdose.

While people suffering from addiction seem to have little trouble getting opioids, Narcan is much tougher to find, for the addicts themselves and for non-addicts who could administer it. Narcan has to be prescribed by a physician, and there is no black market for it like there is for the overdose-causing drugs. Furthermore, it’s expensive – only one drug company, Amphastar Pharmaceuticals, manufactures it, and it costs $42 per two- dose kit. Many pharmacies do not even carry Narcan– it is typically only available in ambulances and hospitals, places that people who suffer an overdose often do not reach in time. Studies and reports from experts has revealed that half of opioid users who are not availing any treatments from rehabs near LA to get rid off drug addiction die alone, but studies and reports from drug users suggest that some do not die alone meaning meaning that having Narcan readily available to drug users and those that associate with them has the potential to save many lives.

I went to a Narcan training session at Boston Medical Center, where some of the staff of the addiction unit where I was volunteering were quickly taught how and when to administer the drug. Anyone over 18 can train to become a Narcan administrator in less than half an hour, and can apply for two doses at a time. However, these training sessions are rarely advertised to the general public, and are mostly attended by medical personnel. The administration of Narcan is straightforward: it comes in a single dose vial, and is sprayed into the nostrils as soon as the signs of an overdose are detected. Remarkably, Narcan can stop any opioid overdose, even when a person has stopped breathing. As long as Narcan is administered before death, an unconscious person will wake up and, after initial withdrawal-related discomfort, recover.

After the training concluded, the doctors and nurses in the room talked about their own patients and the benefits that Narcan could provide if it was more readily available. One of the most vital components of treating addiction, as I saw firsthand during my time at the hospital, is building an extensive support network for the addict that moves beyond just physicians and therapists and includes family members and friends as resources to turn to for help. The stronger an addict’s support system is, the more likely he or she is able to recover rather than experience a fatal overdose. Providing Narcan to the friends and family of an addict could greatly improve patient outcomes, allowing them to stop an overdose as soon as they see the signs of it. However, Narcan remains an under-publicized, overly expensive drug, whereas the opioids that can cause an overdose are highly accessible to almost anyone.

Improving the availability of Narcan will not solve the underlying opioid problem in this country. Physicians continue to overprescribe painkillers and create new addicts, and heroin seems to get cheaper and cheaper each year. Narcan is not nearly as profitable for pharmaceutical companies to manufacture as painkillers, which are lucrative precisely because they cause addiction. Right now, naloxone training is only available in 17 states; Missouri is not among them. State and federal governments must step in to support the distribution and production of Narcan so that the lifesaving drug can fulfill its potential to avert overdose deaths, giving addicts another chance to recover.