Is an “over the counter” overdose antidote a good move?

Posted on September 26, 2015

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If you’ve ever been in or around the world of drug addiction, then you probably know all about the drug Naloxone (Brand name: Narcan). Narcan is a lifesaving “overdose antidote” (available in both injection and nasal spray), that can completely rid the body of opioid molecules in a matter of minutes and restore breathing in a patient.

In a recent power move by retail pharmacy giant CVS, you can now get Naloxone without a prescription if you live in any of the following 14 states: Arkansas, California, Minnesota, Mississippi, Montana, New Jersey, North Dakota, Pennsylvania, South Carolina, Tennessee, Utah, Wisconsin, Rhode Island or Massachusetts. They are looking to expand to other states as well (…come to Georgia ASAP…please and thank you!)

Discussions surrounding Narcan tend to get a little heated, as did yesterday with a friend of mine. “Tough love” critics of this move argue that increased access would reduce accountability for drug addicts, and enable addiction without consequences; while proponents believe that giving addicts a greater chance of survival is of utmost importance and a fatal consequence isn’t a lesson. After all, “a dead person cannot get clean”.

So is publicly available Narcan “good or bad”? As someone who frequently interacts with people dealing with addiction, I think the answer is a lot less straightforward, but is more of a positive move. Here’s why:

First, let’s address the fact that for the most part, addiction itself is not planned. 

Nobody plans to be mentally, physically and emotionally dependent on a drug. Most addicts didn’t wake up one morning and say “Hey, I think it’ll be cool to become an addict and start ruining my life and my family’s life today”. People do drugs for different reasons, they think drugs are a solution to various problems. Also, the notion that drug users can simply just “choose to get clean” shows a deep misunderstanding of the way addiction works. The compulsions typical of addiction are complicated by real neurological changes that are not under conscious control. Furthermore, Narcan critics tend to focus on addicts and ignore patients who become tolerant to opioids due to cancer or chronic pain. It is possible for chronic pain patients to accidentally overdose in their desperate need to get pain relief.

Lets also take a look at some statistics…

According to this report, nearly 44,000 people die from drug overdoses every year, a number which has more than doubled in the past 14 years, half of them related to prescription drugs. A 2011 report also showed that almost 5 people per hour died of overdose in the U.S. in 2011, a total that exceeded car accidents and even gun incidents.

Enter Naloxone

According to this government study, the use of naloxone kits resulted in almost 27,000 drug overdose reversals between 1996 and 2014. The drug is proven to be highly effective. It saves lives. It has no potential for abuse, and its effectiveness is time-based. The faster one can get it, the better their chances of survival. What’s the harm in making it easier to get the drug, so you can help people stay alive?

Treating the complication of bad decisions does not encourage people to make more bad decisions.

Critics who say it increases complacence and discourages addicts from getting sober, let me ask you this? Does having access to Plan B over-the-counter make you more inclined to have unprotected sex?  Does the availability of over-the-counter insulin make you more complacent about your diet and lifestyle choices?

You get where I’m going with this. Increased access to a drug is not in any way proportional to reduced personal accountability for what it treats. Narcan has always been readily available at several doctors offices and clinics. Even police agencies carry around Narcan as a way to give quicker treatment before paramedics arrive. By CVS not needing a prescription, it is only becoming “more available”.

While I agree that the use of Narcan along with inpatient addiction programs is definitely more effective for addicts in the long-run, there is also nothing wrong with giving someone a better chance of survival after an unfortunate incident. If a community is well educated on how to recognize an overdose and administer the medication, the initial life-saving benefit of over-the-counter Narcan cannot be rivaled.

Drug addiction shouldn’t punishable by death and Narcan allows people live.

What are your thoughts? Are you for or against increased access of Narcan at retail level?

P.S – Naloxone is still available with prescription in other states.

Image credit: CDC.gov

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