Powerful Overdose Drug + No Prescription = Recipe for Trouble?

Narcan is now being offered over the counter, a move some say will save lives while others see it as a dangerous substitute for emergency care.

As an Ohio nonprofit begins selling a popular overdose prevention medication over the counter, are we moving in the wrong direction in fighting addiction?

A nonprofit organization in Ohio’s Franklin county is the first to start selling Narcan (the brand name for naloxone) without a prescription, according to the state board that oversees distribution.1 The drug is being dispensed through an AIDS Resource Center Ohio subsidiary, AMC Ohio Pharmacy in the Short North. The drug became available at the pharmacy in September 2015, according to a release from the resource center.

“We believe it is a natural extension of our work as a nonprofit, community health-focused organization that deals with issues relating to public health,” said Joel Diaz, a spokesman for the resource center. “We have a long history of working with marginalized communities and don’t shy away from the issues that are overlooked because of the nature of the work.”

While there’s no age restriction to the distribution of the drug, those receiving it do have to undergo a brief counseling session. In addition, patients must purchase a minimum order of two doses of the nasal spray and it’s not cheap. That order totals $100, but the drug may be billed to insurance or Medicaid.1

Other independent pharmacies across Ohio are beginning to follow suit. One or two a week have started offering naloxone, but the chain stores have yet to follow, said Cameron McNamee, a spokesman for Ohio’s state pharmacy board.

The ABCs of Narcan

In order to develop an informed opinion, it’s important to understand just what Narcan is and how it works. The brand name version naloxone is said to help prevent overdoses by reversing the effects of narcotics. It can be administered with a syringe with a tip that sprays the drug up the nose of someone who has overdosed on heroin or a prescription opiate. It may also be injected in the muscle, vein or under the skin.

This opioid antagonist is used for the complete or partial reversal of opioid overdose – specifically morphine and heroin — to counteract life-threatening depression of the central nervous system and respiratory system, allowing an overdose victim to breathe normally. It is not addictive and only works if a person has opioids in their system; the medication has no effect if opioids are absent.3

Narcan is not without side effects though. Common reactions include flushing, dizziness, tiredness, weakness, nervousness, restlessness, irritability, body aches, diarrhea, stomach pain, nausea, fever, chills, goosebumps, sneezing, shortness of breath or runny nose.2 Some users experience more severe side effects including agitation, hypo- and hypertension, cardiac arrhythmias, dyspnea, pulmonary edema, encephalopathy, seizures, coma and death. In addition, opioid withdrawal syndrome may occur in some patients given large doses of Narcan.2

The Future of Overdose Prevention?

Drug overdose is the leading cause of accidental death in the United States, causing more deaths than motor vehicle crashes. According to the Centers for Disease Control and Prevention (CDC), overdose rates have increased roughly five-fold since 1990. 3

According to the CDC, overdose rates have increased roughly five-fold since 1990.

Providing overdose prevention, recognition, and response education to drug users and their neighbors, friends, families and the service providers who work with them is a harm reduction intervention that saves lives, according to HarmReduction.com.

Obviously, if we can save a life, we should, but will having access to naloxone give heroin users and other opiate abusers a false sense of security, making them feel invincible in the face of powerful and deadly drugs?

Narcan is not a substitute for emergency medical care for someone in the throes of an overdose, but the medication has been known to save lives. The effect this new distribution method may have on overdose rates in the future remains to be seen.

If you or a loved one is struggling with an addiction and a co-occurring disorder, call us today. We’re available 24 hours a day, seven days a week and can provide information on treatment programs, help with insurance and answer questions about the treatment process.

1. Naloxone Available Without Prescription; This Week News; October 2015; Seman Jr., Gary; http://www.thisweeknews.com/content/stories/clintonville/news/2015/10/05/amc-ohio-pharmacy-naloxone-available-without-prescription.html
2. Narcan Side Effects Center; RxList.com; http://www.rxlist.com/narcan-side-effects-drug-center.htm
3. Overdose Prevention; HarmReduction.com; http://harmreduction.org/issues/overdose-prevention/

Written by Wendy Lee Nentwig

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