Narcan availability raises hope, but there are uncertainties

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There is hope in the news that the leading version of naloxone, the No. 1 drug used to reverse opioid overdoses, will soon be available without a prescription. Making it easier to obtain the life-saving drug should save lives, but the devil, as they say, may be in the details.

We must continue fighting the national opioid crisis on several fronts. But while we work to stop the flood of opioids into the U.S. and into the hands of the many Americans who have become addicted to them, maybe we can at least stem the mounting toll of unnecessary deaths.

Drug overdoses are linked to more than 100,000 deaths in the U.S. each year, with opioids the main culprit. Recently, synthetic opioids lead the list of lethal overdoses. Fentanyl is worst of all.

Consider this: Fentanyl, a synthetic that's 50 times more potent than heroin yet cheap to manufacture, is the leading cause of death of Americans ages 18 to 49.

And it's not just in crime-ridden areas. The opioid crisis gained momentum through the overuse of prescription drugs such as OxyContin. Many people who got hooked on drugs prescribed by a doctor eventually turned to illegal sources.

So it will be good when it's easier for people to get the nasal spray Narcan, the leading version of naloxone used in overdose cases.

It remains to be seen how great a difference it will make to offer Narcan over the counter. Manufacturers that make generic naloxone similar to Narcan may also ask the FDA to make their drugs available without a prescription.

Naloxone already is available without a prescription, because all 50 states allow pharmacies to sell it upon request. It's also distributed by community groups and is carried by emergency medical personnel and police.

But there are problems: Some pharmacies don't carry it. Many addicts don't take advantage of community groups. People with someone who's overdosed may hesitate to call for assistance.

Then there's the stigma. Some people are hesitant to ask a pharmacist for Narcan or ask their insurance to pay for it because they don't want themselves or loved ones branded as an addict.

The hope is that if people can buy Narcan easily, say at a convenience store or online, they will be more likely to have it when needed.

Price is another factor. People who have overdosed need repeated doses of Narcan if they don't wake up and breathe normally within 2-3 minutes. Two doses of Narcan usually cost between $50 to $100. It's not known what price Emergent, the maker of Narcan, will set, or whether insurance plans will cover it when a prescription isn't required. An estimated 20% of people with substance abuse problems lack health insurance.

There's no telling how many stores will stock Narcan or whether people will know how to administer Narcan. (The FDA suggested that Emergent make directions on the package easier to follow.)

Anyone who administers naloxone to a person who's overdosed should also call an ambulance.

Despite these uncertainties, anyone who overdoses has a better chance of survival with Narcan. Anyone who might be in danger of opioid overdose, or around those who are, should have it available.

Fighting the deadly opioid epidemic will require continued concerted action at the federal, state and local levels. It's going to require money and innovative ideas. We need stronger law enforcement, including along our borders.

We need more education about the dangers of fentanyl, and more intervention locally. We need close monitoring of what drugs are prescribed. We need research to find safer ways of managing pain.

In the meantime, making Narcan more readily available should help prevent senseless deaths.

FROM AN EDITORIAL IN THE VIRGINIAN-PILOT