Nine million more prescriptions for the antidote to opioid overdose could have been prescribed last year if medical providers had followed federal guidelines.
Rural areas are particularly less likely to have access to the antidote, called naloxone, that reverses the effects of an overdose, according to an issue of the Centers for Disease Control and Prevention’s Vital Signs publication released Tuesday. The CDC reported that, in all, medical providers tend to prescribe naloxone once for every 70 high doses of prescription painkillers.
“We have a lot more work to do. This is a priority to provide life-saving rescue medication to people who are at risk for overdose… We are not as far along as we’d like to be,” Dr. Anne Schuchat, the CDC’s principal deputy director, said in a call with reporters.
Public health officials consider naloxone to be a key element in reversing deaths from prescription painkillers, heroin, and fentanyl, which together claimed at least 47,600 lives in 2017. The antidote has been used by medical responders and police officers for decades to awaken people who are overdosing, but the Trump administration has urged more laypeople to carry it.
Despite the 9 million prescription shortfall the CDC reported Tuesday, the administration’s efforts appear to be paying off to some extent. The study showed that naloxone prescriptions doubled from 270,000 in 2017 to more than 556,000 in 2018, while high doses of opioid prescriptions fell by 21%. In 2012, naloxone prescriptions were only 1,282.
“We are moving in the right direction, but not fast enough,” Schuchat said. Much of the problem, she said, was that a lot of people still don’t know about naloxone.
Health and Human Services Secretary Alex Azar acknowledged the improvement in a statement but said the report was “a reminder that there is much more all of us need to do to save lives.”
The Trump administration has embraced naloxone, despite concerns raised by critics over the years that it enables addiction. While the drug can save lives, it is not a treatment for addiction. A person who had an overdose and is revived by naloxone goes into painful withdrawal and in some cases become violent. People who use opioids may overdose and be awakened several times over the course of their addiction, and sometimes multiple doses are needed to save someone.
But the Trump administration has concluded that naloxone is an important first step in getting people into addiction treatment. The CDC recommends doctors prescribe naloxone to patients who are getting particularly high doses of opioids to treat pain, and to patients who are taking both opioids and benzodiazepines, such as Xanax, as the mixture can lead to an overdose.
CDC director Robert Redfield said the agency would keep emphasizing to doctors and other healthcare providers that it was important for them to prescribe naloxone. The CDC said that pharmacists needed to stock naloxone and show patients how to use it, that states should let pharmacists dispense it to patients without a prescription, and that insurers should consider how to provide the drug to beneficiaries so that people aren’t paying large amounts for it out of their own pockets.
Naloxone kits come in the form of a nasal spray called Narcan or an auto-injector that is roughly the size of a cell phone, called Evzio.
