Pubdate: Mon, 14 Apr 2014
Source: San Francisco Chronicle (CA)
Copyright: 2014 Hearst Communications Inc.
Contact: http://www.sfgate.com/chronicle/submissions/#1
Website: http://www.sfgate.com/chronicle/
Details: http://www.mapinc.org/media/388
Author: Melody Gutierrez
Bookmark: http://mapinc.org/topic/naloxone

PUTTING OVERDOSE ANTIDOTE IN REACH

Life-Saving Naloxone May Become Easy to Purchase

SACRAMENTO - Slowly, trembling, she inserted the needle into a sponge 
and continued rescue breathing on the plastic mannequin. This could 
be her son. One one-thousand. These could be his cold lips. Two 
one-thousand. She squeezed the clear liquid into the sponge arm of 
the mannequin. Three one-thousand. Four one-thousand.

The constant worry that accompanies having a 25-year-old son addicted 
to heroin has taken a toll on the retired schoolteacher from a 
Sacramento suburb, who asked that her name not be used to protect her privacy.

"What causes kids to be addicts?" she asked through tears. "That 
racks my mind. How much more can a parent take?"

She left an addiction support group clutching what she came for - 
Narcan, a drug often referred to as the antidote to opiate overdoses. 
More commonly known by its generic name, naloxone, the injectable 
drug reverses the potentially fatal respiratory depression caused by 
overdosing on medications such as morphine and oxycodone or illicit 
drugs like heroin and cocaine.

Once only found in emergency rooms and a handful of community 
overdose prevention programs, naloxone is finding its way into more 
medicine cabinets as lawmakers, medical professionals and advocates 
push for increasing access to the life-saving drug.

A bill making its way through the Legislature would dramatically 
boost the drug's availability by allowing it to be sold without a 
prescription at pharmacies across the state.

Needed solution

"California has been trying to wrap its arms around a growing number 
of overdose deaths," said Meghan Ralston of the Drug Policy Alliance, 
which backs the bill. "We need low-cost, effective ways to address 
the problem."

AB1535 by Assemblyman Richard Bloom, D-Santa Monica, is one of them, 
Ralston said. Some community outreach groups already distribute the 
drug through a partnership with a coordinating doctor after training 
recipients on how and when to use the overdose antidote. Proponents 
of the bill say making naloxone available over the counter at 
participating pharmacies increases the number of places friends, 
family and users themselves can find the rescue drug to keep on hand 
for emergencies.

The bill unanimously passed its first committee Tuesday with 
bipartisan support and has no listed opposition.

"It addresses the problem in a meaningful way that doesn't cost 
taxpayers money," Ralston said.

The current draft of the bill calls for buyers to receive some 
counseling on drug treatment programs and education about how to 
recognize an overdose. Pharmacists also would have to undergo 
additional training on the drug.

"The emphasis is on making this drug more accessible," Bloom said. 
"If we wait until they get to the emergency room, it may be too late."

Overdose fatalities are a leading cause of accidental death in the 
United States, killing 38,000 people in 2010, according to the most 
recent data from the U.S. Centers for Disease Control and Prevention. 
Sixty percent of those deaths were from pharmaceutical drugs, 
according to the 2010 CDC data. For the past five years, more 
Americans ages 25 to 64 died as a result of drug overdoses than in 
traffic accidents.

Advocates say overdose fatalities would be much greater if not for naloxone.

San Francisco became the first California city in 2003 to publicly 
fund the distribution of naloxone, resulting in more than 900 lives 
saved over the past decade at a cost of about $73,000 a year.

Thousands treated

The CDC's Morbidity and Mortality Weekly Report credited naloxone 
with successfully reversing 10,000 drug overdoses over 15 years.

Last month, U.S. Attorney General Eric Holder urged law enforcement 
agencies to train and equip officers with naloxone after calling the 
rise in overdose deaths from heroin and prescription painkillers an 
"urgent public health crisis."

The San Diego County Sheriff's Department announced deputies would 
soon begin carrying the drug.

"The medication is remarkably effective," said Gantt Galloway, a 
pharmacist and executive director of the New Leaf Treatment Center in 
Lafayette. "There are not a lot of medications that have specific 
antidotes, but opiates are effectively treated by this."

Two weeks ago, Galloway began a monthly training for the public at 
his drug treatment center, where naloxone is distributed. Among the 
things taught is the importance of calling 911 during a suspected 
opiate overdose, even when naloxone is given, since the drug wears 
off after an hour and overdose symptoms can return.

The nonaddictive drug has no side effects when given to someone who 
isn't suffering from an opiate overdose. It currently comes in an 
injectable syringe or nasal spray for $15 to $25, although some 
community groups, like Galloway's, provide it free or by donation.

The FDA announced last week that it has approved another version of 
naloxone, administered through a small hand-held auto-injector 
similar to an EpiPen - an injector that delivers a measured dose of 
epinephrine, which combats severe allergic reactions. Called Enzio, 
it is designed to be easily used by laypeople who suspect an opioid overdose.

Being prepared

"Some people think this is enabling," said Mardi Wally of Sacramento, 
who attended a training session last week at Harm Reduction Services 
in Sacramento in order to receive a prescription for naloxone. Her 
husband, she explained, sometimes mixes pain medications with 
alcohol. Wally said she wants to be prepared, just in case the worst happens.

"I believe in helping people when you can and where you can," she said.
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MAP posted-by: Jay Bergstrom