By Dane O’Leary
The opioid epidemic is the most severe drug crisis in United States history. Ever since painkiller abuse became a large-scale problem in the late 1990s, annual addiction and overdose death rates have continued to climb. To make matters worse, the gap between the current and previous years’ rates has been getting bigger, meaning that the problem is not only getting worse but worsening at a faster pace.1 As such, there are now more people dying from opioid overdose than any other form of preventable death, including car accidents and gun violence.2 If the opioid epidemic was a secret code, we would still be nowhere close to cracking it.
Therefore, it stands to reason that if we can’t yet solve the opioid crisis, we should at least try to limit the damage it can cause. In other words, can we find ways to decrease the injuries, disease transmission and overdose deaths, each of which are inherent byproducts of opioid drug use?
Arizona legislators have been enacting a strategy that may have a momentous impact on rates of opioid overdose deaths, at least those occurring within the state. This particular strategy has involved expanding access to life-saving drug Narcan in a huge way.
What Is Narcan?
Narcan is often lauded as a miracle drug that’s capable of stopping an opioid overdose. No, you’re not reading that incorrectly. If administered early enough in the overdose process, a dose of Narcan can reverse the effects of opioids, thereby preventing death.
Sometimes colloquially referred to as a “save shot,” Narcan — or naloxone hydrochloride — typically comes in the form of a nasal spray and is an opioid antagonist.3 This means that the substance creates strong bonds with the brain’s opioid receptors,4 essentially blocking the effects of opioids, including prescription painkillers and heroin.
Another substance that contains naloxone is Suboxone. Often used as a maintenance drug in a similar manner as methadone, Suboxone contains buprenorphine and a small amount of naloxone. At such a small amount, the naloxone in Suboxone helps the drug to block the effects of opioids and offers a level of protection from abuse. However, when administered in a much larger dose (i.e., via a dose of Narcan), naloxone can forcibly expel heroin, painkillers and other opioids from the system, which is why it’s so effective in an overdose situation.
Arizona Expands Access to Life-Saving Drug
Being that the drug is able to effectively reverse a situation that was previously thought irreversible, you might expect Narcan to be readily available. But that’s not been the case. Although there has been a major push to make Narcan available to the public, the actual implementation of this strategy has been incremental. In fact, it’s largely been local and state-level governments that have been taking advantage of the life-saving miracle drug with Arizona now among them.
Prior to the rollout of new legislation, emergency responders needed a certain level of certification before they could administer Narcan. Unfortunately, with drug overdoses becoming a bigger and bigger problem, there were many overdose victims who weren’t able to receive Narcan in time due to responders not being certified or simply not having access to the drug. Normally, it would make sense to require extensive training and certifications to administer potentially dangerous drugs, but Narcan is not a dangerous drug because of the way that it works. For this reason, limiting the use of Narcan actually hinders the drug’s efficacy rather than offering protection.
In 2015, Arizona became the 26th state to pass legislation to allow more emergency responders to administer Narcan.5 Not only are more responders able to administer Narcan, there’s an ongoing training program to help them become more proficient with Narcan, including learning how to administer it and how to quickly determine when the drug is necessary.6 Meanwhile, Arizona officials began to agree that, with time being of the utmost importance in stopping an overdose, access to Narcan should also be granted to the public.
As Narcan has become a more important tool in the midst of the opioid crisis, many states have been amending their laws to make the drug easier for the public to obtain. Arizona Attorney General Mark Brnovich has been approaching the issue in parallel to the widespread availability of opioid drugs on the street. If drug users can easily access OxyContin and heroin, the public should have access Narcan, which is why Brnovich has been working with pharmacies to increase the drug’s availability. In January 2017, Walgreens became the first pharmacy to offer public access to Narcan at all 240 locations throughout the state of Arizona.7 Then in May 2017, CVS joined Walgreens as the second pharmacy to offer Narcan without the need for a prescription.8 According to reports, the nasal spray form of Narcan costs $110 while the injectable form costs $40.
At a press conference to announce the partnership between the Arizona government and CVS, Attorney General Brnovich made it clear that access to Narcan isn’t the only way he hopes to loosen the chokehold of the opioid crisis. “We’re [also] going after doctors that over-prescribe, and we’re going after pill mills”, Brnovich said, referring to clinics that prescribe controlled substances to patients for non-medical use. “This is an epidemic, and we as a society need to do something about it.”
While Arizona residents have gained access to Narcan without the need for prescriptions, there have been 46 other states who have amended their laws in some way to make it easier to obtain Narcan.9 Although making the “save shot” more accessible can’t stop opioid abuse overall, there’s no question that it will help to decrease the frequency with which opioid overdoses are fatal.
1 Katz, Josh. “Drug Deaths in America Are Rising Faster Than Ever.” The New York Times.
2 Christensen, Jen. “This is America on drugs: A visual guide.” CNN.
3 “Narcan: Indications, Side Effects, Warnings.” Drugs.com.
4 “Naloxone — A Potential Lifesaver.” National Institute on Drug Abuse.
5 Novak, James. E. “Arizona Passes Law Allowing First Responders to Administer Lifesaving Overdose Drug.” The Law Office of James Novak.
6 Pioneer, Parker. “Opioid emergency response data released.” Parker Pioneer.
8 Gundran, Robert. “CVS is the latest to ease access to opioid-overdose drug in Arizona.” The Arizona Republic.
9 Bulloch, Marilyn. “As Naloxone Accessibility Increases, Pharmacist’s Role Expands.” Pharmacy Times.Share