Sections
Log in
Top News
U.S. News World News Featured Voices
Odd News
Entertainment
Movies Music TV
Sports
Soccer NFL NBA MLB
Photos
News Entertainment Sports Features
More...
Defense Featured Science Health Video Archive Almanac
About Feedback Privacy Policy
About Feedback Privacy Policy
Search
Voices
Oct. 21, 2019 / 8:06 AM

More people should have access to naloxone to reverse opioid overdoses

By
Tarlise Townsend and Freida Blostein
Missouri Gov. Eric Greitens displays a bottle of Narcan, a naxolone nasal spray, before signing legislation that will provide tools to fight opioid addiction in Olivette, Mo., in 2017. The law gives approval for the director of the Department of Health and Senior Services to issue an order making Narcan available across the state. File Photo by Bill Greenblatt/UPI | License Photo

Oct. 21 (UPI) -- Forty-seven thousand Americans died of opioid-related overdoses in 2017 -- similar to the number of deaths from car accidents and gun violence.

That number could have been much lower had more people received naloxone, a medication that reverses opioid-related overdose.

Naloxone is safe, non-addictive and highly effective. And it does more than save lives: When used shortly after overdose, naloxone reduces the likelihood of long-term brain damage from diminished blood flow.

Available as an injection or nasal spray, naloxone can be administered by anyone trained to do so -- assuming, that is, that someone has it on hand at the scene of the overdose.

RELATED First trial begins in sweeping legal fight to decide who's responsible for opioid crisis

Restricted access

Police, firefighters and medical first responders are increasingly equipped with naloxone.

However, the true first responders to an overdose often aren't professionals but the friends, family and peers of people who use heroin and other opioids. Relatively few of these "laypeople" have access to naloxone, which is available via community distribution, a doctor's prescription or, in states that allow naloxone to be sold without a prescription, from a pharmacy.

RELATED Poll: 46% in U.S. have seen alcohol or drug abuse in family

While at least 41 states allow pharmacists to dispense the medicine without a prescription, many pharmacies fail to actually stock it. In California, only a quarter of all pharmacies carried naloxone last year.

As opioid-related deaths have soared, there's been an increase in programs working to get naloxone into the community. Health centers like Prevention Point Pittsburgh, for example, train people likely to witness overdose on how to recognize the signs and give them free naloxone.

However, the most recent available data suggest that relatively few communities with high rates of opioid-related deaths have such programs.

RELATED Judge: Philadelphia safe-injection site does not violate federal law

Even emergency medical personnel may not have naloxone when they need it.

Most U.S. states only authorize intermediate- and advanced-level EMS to carry and administer the drug. But in many parts of the country -- particularly rural and tribal areas -- EMS with basic training are often the only medical first responders immediately available in emergencies.

'Moral hazard'

One impediment to increased naloxone access is the argument that reviving overdose victims will encourage opioid use.

Naloxone critic Dr. Harold Jonas, founder of the website Sober.com, has warned healthcare providers that naloxone creates a safety net, making people think "they don't need treatment for substance abuse and ... continue using at will."

The fear that life-saving interventions encourage reckless behavior -- a concern historically used to oppose everything from condoms to seat belts -- is called "moral hazard."

There is no peer-reviewed, empirical evidence that naloxone use encourages opioid use. But this argument remains pervasive.

Often, politicians combine moral hazard with budgetary arguments to oppose broader naloxone distribution.

The prices of some naloxone products have been rising. Between 2009 and 2016, naloxone manufactured by Amphastar almost doubled in price, from $20.34 to $39.60 per dose.

In 2017, the city of Middletown, Ohio, spent almost $35,000 on naloxone administered by EMS in 966 opioid overdose calls -- up from $11,000 and 532 calls in 2016.

Citing cost, Middletown Councilmember Dan Picard has said the city should refuse to resuscitate people who overdose repeatedly.

Naloxone is cost-effective

Since the opioid crisis disproportionately hurts low-income communities like Middletown, our team of health policy and epidemiology researchers at the University of Michigan conducted a study to determine whether naloxone is a good use of the scarce resources available to reduce opioid-related deaths.

Our study, published in International Journal of Drug Policy, found that naloxone is extremely cost-effective.

We analyzed the cost-effectiveness of giving naloxone to three different groups: laypeople, police and firefighters and EMS.

When all three groups have naloxone, it costs about $16,000 per year of "high-quality" year of life saved. We accounted for quality of life as well as quantity, since problematic substance use increases the risk of hepatitis, HIV and other health serious illnesses.

As life-saving interventions go, $16,000 per high-quality year of life is an excellent deal. The public defibrillators used to revive people in cardiac arrest come out to around $53,797. And a breakthrough class of new cancer drugs run $100,000 to $150,000 per high-quality year of life saved.

Naloxone actually saves society money when we take the lost economic productivity from fatal overdoses into account, we found. Hard-hit communities may see naloxone as an expense -- but they're actually saving the city money by keeping more of its workforce alive.

This finding holds even when we add in a city's criminal justice costs associated with opioid use.

Naloxone would remain cost-effective even if the "moral hazard" concerns were true. We found that overdose rates would have to rise 20 percent for lay distribution of naloxone to cease being cost-effective -- a large margin of error for an unsubstantiated worry.

Moral imperative

Our research determined that the most cost-effective strategy is to distribute naloxone to all three groups: laypeople, police and firefighters and EMS.

If low-income communities can't afford that much naloxone, however, the next-best scenario is to give the medicine to laypeople plus at least one first responder group -- either police and fire or EMS.

Getting naloxone into lay hands is so critical because many overdose witnesses hesitate to call 911 due to fear of arrest, stigma or loss of government benefits like subsidized housing. No matter how many first responders have naloxone, the victims in those cases cannot benefit from it. They need someone close by, like another person using opioids, to revive them.

But emergency responders should have naloxone as well, since overdose witnesses may not always have naloxone or be able and willing to use it.

Sometimes, a single naloxone dose can save two lives.

In 2018, clinicians in North Carolina treated a pregnant patient who had recently overdosed. Friends had used naloxone to reverse the overdose, allowing her to enter treatment for substance use.

A few months later, she gave birth to a healthy baby. The Conversation

Tarlise Townsend is a joint PhD student in health policy and sociology and Freida Blostein is an epidemiological science PhD candidate at the University of Michigan.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

  • Topics
  • Most U.S.
  • HIV

Latest Headlines

Kazakhstan, Uzbekistan key to U.S. interests in Central Asia
Voices // 1 day ago
Kazakhstan, Uzbekistan key to U.S. interests in Central Asia
Dec. 6 (UPI) -- A geostrategic opportunity is opening for America in how Washington can advance the U.S. interests in a quickly shifting landscape in Central Asia. Two countries, Kazakhstan and Uzbekistan, will play a key role.

Young protesters in Iran, Iraq will not be cowed
Voices // 2 days ago
Young protesters in Iran, Iraq will not be cowed
Dec. 5 (UPI) -- More than 1,000, mostly young, protesters have been murdered by Iran's theocratic fascist regime in the past two weeks, with more than 4,000 injured and 12,000 arrested.

NATO must recognize Russia as political, economic threat
Voices // 3 days ago
NATO must recognize Russia as political, economic threat
LONDON, Dec. 4 (UPI) -- This week, NATO heads of state and government gather at the Grove Hotel, the former estate of the dukes of Clarendon outside London, for a summit marking the alliance's 70th anniversary.

Growing Christian movement agrees with Rick Perry that God chose Donald Trump
Voices // 4 days ago
Growing Christian movement agrees with Rick Perry that God chose Donald Trump
Dec. 3 (UPI) -- A large number of evangelical Christians in the United States believe that God has chosen Donald Trump to advance the kingdom of God on Earth. Several high-profile religious leaders have made similar claims.

Iran uprising recalls bloody parallels with Hungary
Voices // 5 days ago
Iran uprising recalls bloody parallels with Hungary
Dec. 2 (UPI) -- Iran's nationwide uprising has dark and bloody parallels with the Hungarian uprising of 1956, when tens of thousands of students, leaderless at first, took to the streets of Budapest and were fired on by state police.

Donald Trump's impeachment: 21st century firing on Fort Sumter?
Voices // 1 week ago
Donald Trump's impeachment: 21st century firing on Fort Sumter?
Nov. 27 (UPI) -- Donald Trump can't stay president. But the impeachment inquiry is unlikely to provide sufficiently credible evidence for conviction. If Trump survives this process, do not discount his chances for re-election.

West must intervene to protect Iran's protesters, Mideast democracy
Voices // 1 week ago
West must intervene to protect Iran's protesters, Mideast democracy
Nov. 26 (UPI) -- The international community must take decisive action to limit the further loss of life in Iran. Since protests last began on Nov. 15, at least 300 activists have been killed.

Prince Andrew's 200 charities highlight value of royal patronage
Voices // 1 week ago
Prince Andrew's 200 charities highlight value of royal patronage
Nov. 25 (UPI) -- Around 3,000 organizations have charitable patronage from a member of the British royal family. That number will soon shrink by around 200 as Prince Andrew steps back from his royal duties.

City diplomacy has been on the rise; policies are finally catching up
Voices // 2 weeks ago
City diplomacy has been on the rise; policies are finally catching up
Nov. 22 (UPI) -- The gridlock in Washington can be disheartening at times, but action-oriented pragmatic mayors, who are not as constrained by party politics, can offer a glimmer of hope.

Arab Gulf states expand investment in Central Asia
Voices // 2 weeks ago
Arab Gulf states expand investment in Central Asia
Nov. 21 (UPI) -- As Gulf states diversify their investments away from the United States and Europe, ties between Central Asian countries and the Arab Middle East continue to grow.

Trending Stories

Supreme Court refuses to lift block on federal executions
Supreme Court refuses to lift block on federal executions
Judiciary committee releases report on historical arguments for impeachment
Judiciary committee releases report on historical arguments for impeachment
Arizona couple found dead of likely hypothermia after being buried in snow
Arizona couple found dead of likely hypothermia after being buried in snow
Nashville police capture 3rd of 4 teens who escaped jail
Nashville police capture 3rd of 4 teens who escaped jail
American student freed in prisoner swap with Iran
American student freed in prisoner swap with Iran

Photo Gallery

 
On the red carpet at the International Emmy Awards
On the red carpet at the International Emmy Awards

Latest News

Report: Oceans losing oxygen at rapid rate due to climate change, pollution
Arizona couple found dead of likely hypothermia after being buried in snow
Indian woman dies of burn injuries after being attacked on walk to court
Controversial Nobel laureate avoids questions about his support for Serbs
Denuclearization is off the table, North Korean diplomat tells U.N.
 
Back to Article
/
Back to top
About UPI Contact Feedback Advertisements Submit News Tips
Copyright © 2019 United Press International, Inc. All Rights Reserved.
Terms of UsePrivacy Policy