Doctors Are Not Prescribing Enough Naloxone, Health Agencies Say

By William Georgiades 02/23/17

Why is the use of the lifesaving drug naloxone not being matched by the rise in opioid overdoses?

Man climbing a rising arrow.

As opioid overdoses continue to be an epidemic across the country, health agencies are now calling on doctors to educate patients about the benefits of naloxone and, where necessary, provide prescriptions, according to Consumer Reports.

Both the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) have issued strongly worded statements urging the prescriptions and/or suggestion for states where naloxone can be obtained over the counter.

According to the CDC, opioid overdoses have quadrupled since 1999, accounting for a record 33,091 deaths in 2015. IMS Health reported that there were 220 million prescriptions for opioids in 2015. Yet, there were only 3.2 million prescriptions for the lifesaving drug naloxone that same year, according to a report in the New England Journal of Medicine last December.

The Fix has long reported on the lifesaving benefits of naloxone, a relatively cheap and available drug that can counter the effects of heroin or opioid overdoses by blocking the drug from interacting with the brain's receptors. But clearly, as the epidemic steadily rises, the rate of naloxone prescription—or even doctor and consumer awareness of naloxone—remains low.

The rescue medication, which has been on the market since 1971, comes in the form of an auto-injector or nasal spray for ease of use.

"These new recommendations are helpful, but haven't yet reached most healthcare providers who—along with patients—may underestimate the risks of prescribed opioids for some people," Phillip Coffin, MD, director of substance use at the San Francisco Department of Public Health, told Consumer Reports.

Over the years, naloxone has become more accessible with outlets such as Walgreens, CVS and Rite Aid making the drug available without prescription, some police and fire departments having the drug on hand to combat overdoses, and 46 states allowing the drug to be bought without prescription.

But as awareness and availability increases, so too has the price in some quarters. As Dr. Leana Wen, Baltimore's health commissioner recently told the Baltimore Sun, "We shouldn't be priced out of saving lives. In a time of a public health emergency, we should be making it more affordable and available."

The most dramatic increase in price is with the auto-injector Evzio. In 2014, the two-pack was priced at $690. Today, it is priced at $4,500. CPMC St. Luke’s Hospital Emergency Room Specialist Dr. Hallam Gugelmann recently told CBS News, “It is profiting off of an epidemic and it’s profiting off of other people’s misery.” It should be noted that 31 U.S. senators are already questioning this price hike.

Not all companies are engaging in such price hikes, and versions of naloxone continue to be available for about $135 with insurance. You can also contact your local public health department or community outreach center who may distribute the drug for free.

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William Georgiades is a former editor at EsquireBlack Book, the New York Post and the Grapevine and has written for several publications including New York MagazineVanity Fair, the London Times and GQ. He has been the features editor at The Fix since 2013. You can find him on Linkedin.