Reynolds: Time to make overdose antidote readily available
International Overdose Awareness Day is Saturday, and if it's like every other day in recent history, another 100 Americans -- at least one of them a Long Islander -- will struggle to take their last breaths while under the influence of opioid painkillers, heroin, methadone, cocaine, Xanax or some combination of drugs and alcohol.
As overdose deaths climb, law enforcement is working hard to lock up dirty doctors and other drug dealers. And New York's historic I-STOP legislation, which took effect on Tuesday, will thwart doctor shoppers and limit the distribution of opiates to abusers. But squeezing the supply alone won't save lives.
Not using drugs is the surest way to prevent overdose, but we know that for many, addiction is a chronic and relapsing condition. It's also clear that too many young people are experimenting with prescription meds and suffering fatal consequences. Too many families are losing a race against time as they try to cajole their loved one into treatment for a disease whose calling card is massive denial. Too many treatment facilities are filled to capacity, and too many insurers are refusing to pay for care. So, what do we do for those who are careening through the dark tunnel of addiction and likely to die before experiencing the miracle of recovery?
We give them access to a lifesaving drug called naloxone, which is distributed under the brand name Narcan. Developed in the late 1960s, Narcan reverses opiate overdoses by blocking key brain receptors and counteracting life-threatening central nervous system and respiratory depression. Administered via nasal spray or injection, Narcan is not prone to abuse because it doesn't get you high and has no major side effects if administered in error. It also costs less than $20 per dose.
Emergency personnel have dispensed Narcan for decades, but few nonmedical people know about the antidote. And while it's readily accessible in other countries, it's only available by prescription in the United States. The federal Food and Drug Administration has contemplated over-the-counter availability, but so far hasn't taken action to boost access to the lifesaving drug.
Community access to Narcan happens only through a limited number of state-approved physician-run overdose prevention programs that train participants to recognize the signs of overdose and equip them with Narcan kits. Nassau County routinely runs such training and last year, the Suffolk County Police Department put Narcan into sector cars that typically arrive on the scene before volunteer ambulances. Since July 2012, Suffolk cops have revived more than 60 Long Islanders whose families were subsequently able to arrange drug treatment, rather than a funeral.
Most overdoses are linked to prescription drugs like OxyContin and Vicodin that are easily obtained from family, friends or straight from the medicine cabinet. Shouldn't an antidote like Narcan, which is safe, cheap and proven to save lives, be as easy to obtain? Narcan should be stocked in every first aid kit and every school nurse's office. It should be given to chronic-pain patients who might mix up dosages. Parents of addicted teens should be able to carry it like an epinephrine auto injector for allergies.
New York State lawmakers paved the way for better access in 2006 when they voted to allow trained laypeople to administer Narcan and extended Good Samaritan protections to those who use the drug in good faith.
So what's the holdup? It's apathy more than opposition, though a few naysayers have suggested that distributing Narcan green lights drug use -- the same mindset that allowed AIDS to kill half a million Americans as we bickered about whether a piece of latex would encourage people to become promiscuous.
In reality, the potential to avoid death doesn't encourage drug use any more than the fear of death discourages it. Addiction is an inherently irrational brain disease, but it's also treatable and needn't be fatal. Recovery remains the ultimate goal, and getting a struggling addict breathing again had better not become the best we can do. It is, however, the least we can do.
Jeffrey L. Reynolds is the executive director of the Long Island Council on Alcoholism and Drug Dependence.