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Wider Availability Of Naloxone Could Help Curb Drug Overdose Epidemic

Evening Edition

Aired 4/17/14 on KPBS News.

In an attempt to reduce the epidemic of fatalities from prescription narcotic overdoses, health officials want to broaden access to an effective antidote that doctors have been using for years.

The emergency department at Sharp Grossmont Hospital is the busiest in San Diego County.

Dr. Danielle Douglas, who works in the emergency department, said it’s not unusual for paramedics to wheel in somebody they suspect of overdosing on narcotics.

“Often, they’re not breathing as regularly as someone would if they’re not on narcotics, the respiratory rate is very decreased, and they’re usually unconscious," Douglas explained.

That's when doctors inject a patient with naloxone. Douglas said the drug revives the patient almost immediately.

“Which is great, because it can save someone an intubation, where they end up on a respirator," Douglas said. "It can potentially save them from death, if they’re in the field, and the paramedics get there just in time, and also save them from a lifelong complications from anoxic brain injury."

Naloxone has been around for more than 40 years. It’s been the overdose antidote of choice for ER doctors and paramedics.

It's a prescription drug, but it is not a controlled substance.

In 2001, New Mexico became the first state to make it easier for doctors to prescribe naloxone, and for other providers to use it. Since then, 17 states have followed suit.

With the steady rise in overdose deaths, there are efforts underway to make naloxone more widely available.

In 2010, Diana Pierce’s son Michael overdosed on prescription painkillers.

Even though a nurse who lived in his building came to his aid, Michael died.

Pierce wishes there had been some naloxone on hand.

“I think it could have made a difference with him, if the nurse had had it, or someone in the apartments," Pierce lamented. "It’s like, you know, they put the defibrillators everywhere now...just accessible...save people’s lives.”

To that end, the San Diego County Sheriff’s Department wants to put naloxone in the hands of its deputies. When its pilot program is launched this summer, the Santee station will put nasal atomizers filled with naloxone in all of its patrol cars.

It will be the first law enforcement agency in California to do so.

Capt. James Bovet said San Diego County has seen epidemic levels of drug abuse.

“Starting with prescription medication, and then really morphing into heroin," Bovet said. "And we’ve had many deaths, in all areas, from Poway to Lemon Grove, from children to adults.”

In a survey conducted by the sheriff's department last year, it was found that deputies are typically the very first responders on the scene of emergencies. Bovet said giving deputies a tool to save someone from a fatal overdose fits into their mission.

“That’s our No. 1 priority: the protection of life," he said. "And so really, it’s not unusual at all, it’s something that they do, and it’s just another tool in their bag.”

The FDA has just approved an auto-injector form of naloxone. Doctors could prescribe the user-friendly device to family members or friends of people at risk of an overdose.

There’s also a bill in the California Assembly that would allow pharmacists to dispense naloxone without a doctor’s prescription.

Some critics worry that widespread availability of naloxone could encourage drug use, by eliminating the fear of overdose.

But UC San Diego professor Karla Wagner said there’s no research to support that claim.

She explained providing greater access to naloxone is just one step in a broader strategy.

“And that strategy needs to involve not only getting naloxone into people’s hands, but also educating them about the risk factors and the signs and symptoms of overdose and how to respond appropriately when they see an overdose," Wagner said. "It involves prevention programs that are effective in keeping people from initiating use of opioids in the first place. It includes effective substance abuse treatment.”

Prescription drug abuse is America’s fastest growing drug problem. Overdoses of prescription painkillers and other narcotics killed more than 16,000 Americans in 2010.

Karla Wagner thinks naloxone could be part of the solution.

“Increasing availability of naloxone does have the potential to stem the tide of overdose deaths that we see in San Diego County and we see across the country,” Wagner said.

The county Sheriff’s Department estimates each dual-dose kit of naloxone will cost around $45.

The Department will look for grant funding to cover the $2,500 annual cost of the pilot program. But they say they’ll pay for it themselves if they have to.

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