Can The “Overdose Antidote” be Made Publicly Available? The US Surgeon General Thinks So

Can The “Overdose Antidote” be Made Publicly Available? The US Surgeon General Thinks So

America’s top doctor, Surgeon General Jerome Adams, has made a public advisory announcing that the so-called “overdose antidote”, naloxone, should be readily available to the public so that more people could have the drug on hand, as it benefits not only those who are at risk of suffering an overdose of particular pharmeceuticals, but their loved-ones as well. Upon release of the statement, many experts, as well as others who advocate public availability, have expressed various ranges of approval and excitement at the news.

Leo Beletsky, who is an associate professor of law and health sciences at Northeastern University, has lauded Adams’s announcement, describing it as “unequivocally positive”.

Some medical professionals with years of experience in the industry would not find the announcement surprising. Prior to becoming the United States Surgeon General, Adams was the health commissioner of the State of Indiana. He was later appointed to the position of the nation’s top doctor. This was due with some credit to his years of experience serving with then-Gov. Mike Pence. Adams promoted a number of approaches so as to reduce much of the harm which is normally associated with overdose response treatment while in Indiana. Among other measures, Adams advocated the ever-wider-reaching availability of naloxone. Upon the outbreak of HIV as of 2015, as was widely-reported in Indiana press, Adams also advocated for a needle exchange to be implemented, on the basis that, since the reuse of needles for drug-use had been correlated with increases in HIV rates.

Medical professionals elsewhere in the practice have advised caution against the idea, however, saying that there is a limit in the best we can realistically hope for in terms of public availability, almost inevitably high cost, as well as what the antidote is actually capable of.

The issue that’s relevant to dying of a substance overdose is an overdose in opioids, and naloxone works by reversing this effect, thereby keeping the person alive. Many medical professionals consider this to be one of the central graces of the antidote in and of itself, and even go so far as to recommend that everyone, plus their loved-ones, should carry a portable dose of Naloxone on them whenever possible.

Traci Green, who is an associate professor at Boston University and specializes in community health sciences and emergency medicine, has said that she would like to see the antidote made readily available to a wider base of people who may need it. Green has done profound research into the crisis of opioid abuse. “It could not have been a better endorsement.”

There has been disagreement, insofar as the advisability of making an antidote publicly available, however. Some medical professionals, such as Diane Goodman, have contested the rationality of responding to opioid addiction with such measures, arguing that there are a great many health issues which some may find themselves facing through their day-to-day lives besides opioid addiction, as well as citing there are numerous forms of treatment which, though limited, are still available. Goodman has said:

I’m not sure it makes much more sense than any of us carrying a bottle of nitroglycerin to treat patients with end-stage angina.

For example, one notable city which has particularly experienced opioid epidemic is Baltimore, Maryland. The Baltimore Health Department has urged a greater, more widespread carrying and knowledge of naloxone.

Dr. Wen has argued that price reductions can be negotiated by the federal government. At the very least, health agencies and other such organizations can be subsidized so that a sufficient supply can be maintained at affordable rates.

For the time being, the naloxone antidote can already be acquired in a generic form. It’s storable and transportable in a vial, and can be administered intravenously. In addition, it can also be inhaled nasally as a spray. Some variations of this, such as Narcan, are available from such companies as ADAPT Pharmaceuticals.

Naloxone in a purely generic (and intravenous) form is relatively cheap, often with a going price of around 20 to 40 dollars per dose. However, it can go up to 125 dollars for a carton (which contains two doses) of the nasal spray, although it is available at a discount (costing only 75 dollars) for Paramedics, health departments, and other medical responders. Another variation of the antidote called Evzio, made by the Kaleo company, can also be acquired by prescription, sometimes without a copay.

Simple discounts alone are not enough to assuage the costs of naloxone, warn some experts in the field, such as the executive director Justin Phillips, who oversees Overdose Lifeline, a nonprofit based in Indiana, as well as a mother of three. Phillips has said:

Sixty-four thousand people lost their lives (nationally in 2016) – that’s someone every 12 minutes. Ten free kits is not going to be enough.

According to Phillips, Overdose Lifeline’s bread-and-butter is the generic variant of naloxone, partially owing to its being the most affordable version. She goes on to say that, “We need to be able to access naloxone—which I’m told is pennies to make—for the pennies it cost to make it,” Also according to Phillips, she has mentioned the necessity of providing funding for naloxone with Surgeon General Jerome Adams, whom she worked with during their mutual years of service at the health department of Indiana. However, she has not made any mention of discussing any price of the antidote.

Another hurdle is the overall market at large. The deputy director of policy and planning for the Harm Reduction Coalition, Daniel Raymond, has said:

If pharmacies are not seeing a steady stream coming in asking for it, they won’t be incentivized to carry it on their shelves.

As it turns out, there is a rather wide base of sources, which also happens to be completely decentralized, to provide naloxone to those who need it. Some such sources include various health departments at the state and county level, community centers, and churches. Although Raymond does add that this network of sources “meets people where they are,” that network of resources simply lacks the raw horsepower to negotiate lowered costs. He goes on to add that “individual health programs are trying to navigate the crisis on their own, but when you see … growing demand and limited supply, it’s a role for federal intervention.”

There is a glimmer of hope, however. The Energy and Commerce Committee within the House of Representatives are currently deliberating a bill in particular which, if passed, would oblige naloxone of some variation or another to be covered by Medicaid programs at the state level with $300 million, which would also then be authorized for priority availability to and use by first responders. At the time of this article’s printing, it is not required in every state for Medicaid programs to do so.


I am a pop culture and social media expert. Aside from writing about the latest news health, I also enjoy pop culture and Yoga. I have BA in American Cultural Studies and currently enrolled in a Mass-Media MA program. I like to spend my spring breaks volunteering overseas.

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