Researchers at Florida Atlantic University (FAU) are promoting education for healthcare providers on the use and administration of naloxone (Narcan; Emergent BioSolutions) in their treatment programs, in a commentary published in American Journal of Medicine. The opioid receptor antagonist comes as a nasal spray or auto-injector.
At the beginning of this week, 2 panels of FDA advisers voted unanimously to recommend that naloxone is available without a prescription. The FDA will make a final decision in the coming weeks and has a target date of the Prescription Drug User Fee Act of March 29, 2023.
Making naloxone more widely available to emergency workers could prevent up to 20% of opioid overdose deaths.
“The United States accounts for less than 4.5% of the world’s population, but accounts for more than 13% or 2.1 million of the more than 16 million people with opioid use disorder,” Charles H. Hennekens, MD, PhD, author senior, the first Sir Richard Doll Professor, and senior academic advisor at the Schmidt College of Medicine at FAU, said in a press release.
In 2021, more than 100,000 people in the United States died of a drug overdose, which has increased 28.5% since 2020. Premature death from drug overdose is considered a growing epidemic in the United States. Synthetic opioids are contributing heavily to these deaths, with many containing lethal doses of fentanyl – a low-cost, highly potent and often illegally produced compound that can be deadly for all users.
Naloxone can reverse the fatal effects of drug overdose by restoring normal breathing and heart rhythm. It’s recommended as an overdose treatment by the U.S. Centers for Disease Control and Prevention, but FAU investigators envision it being over-the-counter for patients prescribed opioids.
“About 1 in 5 patients prescribed opioids for chronic pain overdose, and more than half take other prescription drugs that can cause overdose, as well as abuse alcohol,” Hennekens said in the press release.
The investigators found that naloxone was prescribed to only 1.4% of every 70 patients who were prescribed high-dose opioids. The investigators also wrote that naloxone should be available in places with portable defibrillators. Naloxone, like defibrillators, can help patients suffering cardiac arrest; in the first case, the patient goes into cardiac arrest due to opioid toxicity in the body.
Training healthcare providers for nasal or auto-injector naloxone can be a cost barrier, but retail naloxone is under $100. That’s less than a quarter of the cost of epinephrine auto-injectors ($400) used to treat anaphylaxis. The team also suggests that health care providers go a step further and educate drug-using patients, along with their families, about the importance of keeping naloxone as a nasal spray or auto-injector at home.
“Now is the time to become more proactive in the fight against opioid-related deaths,” said Allison Ferris, MD, corresponding author, chair of the Department of Medicine and an associate professor at the Schmidt College of Medicine, in a news release. Press. “We propose a call to action for all health providers and state medical societies to ensure the widest distribution and easier availability of naloxone, including over-the-counter, which is likely to be approved by the FDA very soon.”
Reference
Florida Atlantic University. Researchers support the spread of over-the-counter naloxone to prevent drug overdose deaths. News Notice. February 15, 2023. Accessed February 16, 2023. https://www.eurekalert.org/news-releases/979757
