Minnesota doctors question plan to let pharmacists prescribe Narcan

Advocates are promoting a new strategy to increase access to naloxone, the emergency drug for opioid overdoses: Let pharmacists decide when to give it out.

Right now, Narcan and other forms of naloxone can only be dispensed by pharmacists under doctors' orders. But state legislation would make naloxone one of the first drugs pharmacists could prescribe on their own.

Naloxone was a hot topic long before it surfaced in the news of Prince's death; the pop star reportedly received an emergency Narcan dose a week before he died.

Overdose deaths related to prescription opioids and illicit heroin have skyrocketed, so health officials have been expanding access to naloxone. When administered by nasal or IV dose, naloxone blocks opioid receptors in the brain and inhibits opioids — which otherwise can cause a fatal slowing of the respiratory and central nervous systems when taken in excess.

In 2014, Minnesota expanded the list of medical professionals who can administer naloxone under a doctor's authority — from advanced paramedics only to all medical technicians as well as police officers and firefighters. The state also granted immunity to anyone who obtained and administered naloxone to an apparent overdose victim.

Growth in first-responders carrying naloxone has stagnated, though, due to the cost of the drug, and concerns about the agitated and sometimes violent reactions by overdose victims when the antidote kicks in, said Tony Spector of the Minnesota EMS Regulatory Board.

And confusion remains about the public's access to naloxone, said Lexi Reed Holtum, whose nonprofit lobbied for expanded access in 2014. Technically, anyone can receive a nasal naloxone dose, even someone who wants the drug out of concern for a neighbor or friend on opioids.

Other states have granted pharmacists prescribing authority, but the idea faces resistance from the Minnesota Medical Association, which represents the state's doctors. The association favors a compromise by which prescribing pharmacists would at least have oversight from county public health medical directors.

Reed Holtum supports empowering pharmacists: "By not allowing pharmacists to independently dispense, we are creating unnecessary barriers to saving lives."