In the past decade, the U.S. has experienced a surge of fatal opioid overdoses, driven partly by increased heroin use but mostly by the greatly expanded availability of prescription medications (e.g. Oxycontin). One important tool in combating this epidemic is naloxone, a drug that rapidly reverses the respiration-suppressing effects of opioids. Expanding its use has been a goal of President Obama’s drug policy from the first days of the administration, and an increasing number of community members, health and social care workers and police have been trained how to administer it. Some New York police officers give a powerful account of their experiences with the rescue drug in the video above.
However, with the increased demand for naloxone has come an increase in its price. It’s an off-patient medication, so in absolute terms costs are low (up to $40 for the nasal administered naloxone kits that police tend to carry and much less for the injected version distributed by many non-profit service organizations). But even low costs can be a barrier particularly if a drug is provided to cover an entire population (most of whom will never need it) rather than employed to treat an identified individual in need.
That’s why it’s encouraging that The Clinton Foundation has announced that it will attempt to lower the cost and increase the accessibility of naloxone, presumably using the same strategies that were employed successfully to achieve the same goals with HIV-related medications. Another potentially important effort, under consideration in the California legislature, is to allow naloxone to be distributed by pharmacists rather than requiring an individual prescription for everyone to whom it is provided. Although the impact of this policy on public health can’t be known in advance, naloxone does not appear to have serious or common side-effects to weigh against it potentially life-saving benefits, which makes it more reasonable to have it be available over the counter.
Addiction expert Keith Humphreys, PhD, is a professor of psychiatry and behavioral sciences at Stanford and a career research scientist at the Palo Alto VA. He recently completed a one-year stint as a senior advisor in the Office of National Drug Control Policy in Washington. He can be followed on Twitter at @KeithNHumphreys.