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    Combating the growing opioid epidemic with the “rescue shot”

    Ned MilenkovichNed Milenkovich

    Heroin and prescription drug overdoses have reached epidemic levels in the United States, surpassing car accidents and firearms as the leading cause of injury deaths, an annual assessment by the U.S. Drug Enforcement Administration has found. 

    See also: Forthcoming HIPAA audits likely to target pharmacies

    The opioid epidemic has grabbed the attention of politicians, public health officials, and drug company executives alike. U.S. Surgeon General Vivek Murthy called it "a top priority," and the House of Representatives is expected to review several bills specifically aimed at curbing the abuse of heroin and painkillers; the Senate passed similar legislation in March of this year.

    As the country begins to recognize the degree to which opioids are abused, efforts to combat this massive public health issue have been focused on the opioid antagonist naloxone. It has long been used by hospital personnel and emergency medical technicians; now there is a movement to expand access and get it into the hands of first responders, as well as drug users and their family members.

    See also: CMS releases final rule for covered outpatient drugs

    Legal framework

    Forty-six states and the District of Columbia now have laws that allow physicians and other medical professions to prescribe or dispense naloxone. State laws supporting naloxone access fall under three categories:

    * Good Samaritan laws: These laws protect individuals calling for help at the scene of an overdose from being arrested for drug possession.

    * Liability protection/third-party administration: This protects both the prescriber and the bystander who may be administering the naloxone. It also permits prescription of naloxone to bystanders for use on opioid overdose victims.

    * Collaborative practice agreements: These allow pharmacists to prescribe naloxone to at-risk individuals. They may be conducted with individual physicians or on a statewide basis.

    Naloxone specifics

    Frequently sold under the brand name Narcan, naloxone is touted as an important and potentially lifesaving tool in combating the nationwide epidemic that has led an estimated 2 million-plus Americans to become addicted to opioids and one of them to die of an overdose every 19 minutes.

    Naloxone is used to reverse the effects of an opioid overdose by attaching to the same parts of the brain that receive heroin and other opioids, and then blocking the opioids for a period of 30-90 minutes, reversing the respiratory depression that would otherwise lead to death from overdose.

    Ned Milenkovich, PharmD, JD
    This article is not intended as legal advice and should not be used as such. When legal questions arise, pharmacists should consult with ...

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