Pubdate: Fri, 29 Aug 2014
Source: Wall Street Journal (US)
Copyright: 2014 Dow Jones & Company, Inc.
Contact:  http://www.wsj.com/
Details: http://www.mapinc.org/media/487
Author: Arian Campo-Flores

STATES EXPAND ACCESS TO OVERDOSE-REVERSAL DRUG

New Laws Put Naloxone in Hands of Abusers, Their Families and
Peers

Faced with an unrelenting epidemic of heroin and pain-pill deaths,
many states are pushing to make more widely available a drug called
naloxone that can reverse overdoses from such opioid drugs within minutes.

In North Carolina, Louise Vincent, an outreach worker in Greensboro,
has rescued scores of opioid addicts from the brink of death by giving
them naloxone.

Now, she is delivering the drug to those she says are in the best
position to help overdose victims-their friends and family
members-under a North Carolina law passed last year that expanded
access to naloxone.

"It could be the difference between life and death," said Ms. Vincent,
a contract worker for the North Carolina Harm Reduction Coalition, a
not-for-profit organization that has dispensed about 3,000 naloxone
kits statewide since the law took effect.

The program so far has resulted in 125 overdose reversals, said
Executive Director Robert Childs. Deaths from heroin and pain
medications totaled 712 in North Carolina in 2012, according to the
state's Department of Health and Human Services.

Nationwide, overdose deaths from painkillers such as oxycodone rose
23% to 16,917 between 2006 and 2011, according to the Centers for
Disease Control and Prevention. Those due to heroin, which is related
to the opioid drugs, jumped 110% to 4,397 over the same period.

There are now 24 states, along with the District of Columbia, that
have passed laws expanding access to naloxone, 17 of them in the last
two years, said Corey Davis, deputy director of the Network for Public
Health Law's Southeastern region, who tracks such policies. The
measures vary, but common provisions include allowing doctors to
prescribe naloxone to a drug user's friends and family members, and
removing legal liability for prescribers and those who administer the
medication.

Meanwhile, 17 states and the District of Columbia have passed "good
Samaritan" laws that provide limited legal immunity-from drug charges,
for instance-to people who call for emergency help for an overdose,
Mr. Davis said.

The moves are prompted in part by concerns that those present during
an overdose often are reluctant to call 911 because they fear legal
repercussions or may themselves be using drugs, said Traci Green, a
professor of emergency medicine at Brown University who is an expert
on overdose prevention.

The naloxone legislation has drawn support from a broad political
spectrum. While liberal-leaning states like Massachusetts and
Washington have led the way, a naloxone bill sailed through the
conservative Utah legislature this year. A measure in Alabama is being
promoted by a Republican lawmaker who is a police captain.

Still, the proposals have met some opposition, including from those
who argue that making naloxone more accessible effectively condones
opioid abuse, like providing clean needles to heroin users to protect
them from HIV and hepatitis C.

Republican Gov. Paul LePage of Maine vetoed a naloxone bill last year,
saying it would provide "a false sense of security that abusers are
somehow safe from overdose." But this year, after working with
lawmakers on a new naloxone bill, he allowed it to become law without
his signature.

Naloxone was developed in the 1960s to counter overdoses of heroin and
other opioids. It works by displacing the drugs from their receptors
in the brain.

Considered safe and effective by medical experts, it has been stocked
by emergency rooms and doctors' offices for decades. It is now sold as
a generic by pharmaceutical companies including Hospira Inc. and Mylan
Inc. and can be administered by injection or nasal spray.

Naloxone, which requires a prescription, costs about $4 a dose for an
injectable version and roughly $45 for a nasal-spray form, said Dan
Bigg, director of the Chicago Recovery Alliance.

Although legislation has paved the way for greater access to naloxone,
distributing it remains a challenge.

Twenty-six states have at least one police department equipping
personnel with naloxone, according to Mr. Davis. Another way to make
it available is through overdose-prevention organizations like the
Harm Reduction Coalition, which has offices in New York and California
and has dispensed thousands of naloxone kits at needle-exchange sites
and other locations.

Yet another option gaining traction is to make it easier for people to
get naloxone from pharmacies.

In Rhode Island, a so-called collaborative practice agreement among
various parties, including the state Board of Pharmacy and Walgreen
Co. made it possible for anyone to request the drug at any of the
pharmacy chain's locations in the state. As part of the arrangement, a
prescription written by a doctor at a local hospital applies
essentially to everyone.

Under a pact announced last week, CVS Caremark Corp. said it would
offer naloxone without a prescription at all 63 of its Rhode Island
pharmacies.

Health officials in Kitsap County, Wash., just west of Seattle, have
reached a similar agreement with Albertsons supermarket pharmacies
that is slated to take effect soon. And in New Mexico, the state Board
of Pharmacy this year added naloxone to a list of drugs that
pharmacists may prescribe.

So far, only 10 pharmacies in the state regularly stock naloxone, said
Michael Landen, state epidemiologist at the New Mexico Department of
Health. But, he said, the program "has great potential." 
- ---
MAP posted-by: Jo-D