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The Drug That Saves Addicts: FDA Will Discuss Making Naloxone Over-the-Counter

Naloxone is a cheap, safe drug that could save countless people from overdosing on heroin and other opiates. So why isn't it in every first-aid kit?
 
 
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Photo Credit: PunchingJudy on Flickr

 
 
 
 

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When I was injecting drugs back in the mid-1980s, several sneaky killers were haunting addicts. We didn’t know it at the time, but half of all New Yorkers who shot drugs were already infected with HIV and many more were carrying the hepatitis C virus. There was no effective treatment for either disease. Thousands died. And unfortunately, many in the recovery community stayed silent. 

The risk we knew about—overdose—seemed just as implacable. You could reduce the danger by limiting your doses and not mixing similar drugs, such as heroin, Valium and alcohol, say, or cocaine and amphetamines, and that remains good advice. Back then, we fatalistically assumed that this menace pretty much came with the territory.

In 2012, however, both HIV and hepatitis C are not only treatable but amenable to prevention campaigns. New HIV infections among drug users have been cut in half in the last decade, largely by clean-needle programs, which can also fight hepatitis C (though not as effectively).

But some 15,000 people still die annually from opioid overdoses—even though there’s a cheap, effective and safe remedy that could save most of these lives if it were more widely available. With prescription opioid misuse now the main cause of rising overdose fatalities and with the overwhelming failure of ongoing efforts to cut supply, it’s long past time to focus on the most direct way to prevent death by OD.

Since 1996, when  Dan Bigg, of the Chicago Recovery Alliance, first began promoting the idea of distributing the opioid overdose antidote, naloxone, to drug users, overdose has been known to be a risk that can be dramatically reduced. As with needle exchange, however, drug-war politics has meant delays—and many needless deaths. The advocacy of the recovery community needs to be louder this time.

And more ambitious. We need not only to educate people about how to save lives with naloxone but to make it available over-the-counter and start a public-education campaign about why it’s essential for every first-aid kit.

Last month, the  CDC reported that since Bigg started, more than 10,000 successful overdose reversals have been reported by the 188 programs in 15 states that currently provide naloxone and train users to administer it. Over 50,000 doses of the drug have been distributed.

Although some of the treated overdoses might not have been fatal without naloxone, the vast majority likely would have been because the drug is only used if the victim has stopped breathing.

Here are the facts about naloxone (brand name Narcan). It immediately reverses overdoses that involve an opioid, even if alcohol and benzodiazepines like Xanax are also involved, as is true in the vast majority of cases. It’s nonaddictive: in fact, about the only imaginable way to misuse it would be to torture people who are opioid addicted by using high doses to put them into withdrawal.

This property also means that addicted people won’t take extra opioids because they know a rescue drug is on hand: coming around from an overdose via naloxone is stressful, and anyway addicts tend to take the highest dose they have.

The story of  Mark Kinzly, a recovering addict who now runs a harm-reduction program that distributes naloxone but who was himself saved by the drug during a relapse, illustrates why:

Kinzly was watching a Red Sox victory with a friend when he overdosed. “I am a Red Sox fan, but that's not what put me into an OD,” he jokes. He had injected two or three bags of heroin—a dose that he thought he could handle. Dangerously, he had misjudged his tolerance after years without heroin…