Surgeon General Urges More Americans to Carry Overdose Antidote

Megan Brooks

Disclosures

April 05, 2018

In an advisory issued today, US Surgeon General Jerome M. Adams, MD, urged more Americans to routinely carry the opioid overdose reversal agent naloxone (multiple brands).

"Each day we lose 115 Americans to an opioid overdose — that's one person every 12.5 minutes. It is time to make sure more people have access to this lifesaving medication, because 77% of opioid overdose deaths occur outside of a medical setting, and more than half occur at home," Adams said in a news release.

Although naloxone is already being carried by many first responders, such as emergency medical technicians and police officers, the surgeon general is now recommending that more individuals, including those who are personally at risk for an opioid overdose as well as their family members and friends, also keep the drug on hand.

Naloxone, which is delivered by nasal mist or injection, can reverse the effects of an opioid overdose until emergency responders arrive. It is easy to use, safe to administer, and widely available, the advisory states.

All states have passed laws to increase access to naloxone. In most states, individuals can request naloxone from a pharmacist without a prescription. In addition, most states have laws to protect healthcare professionals who prescribe and dispense naloxone from civil and criminal liabilities, as well as so-called good samaritan laws, which protect people who administer naloxone or who call for help during an opioid overdose emergency, the advisory notes.

The cost of naloxone is covered by most health insurance plans; for people without insurance, it may be available at low or no cost through local public health programs or through retailer and manufacturer discounts.

The surgeon general's advisory on naloxone is part of an ongoing response to the sharp increase in drug overdose deaths.

An estimated 2.1 million people in the United States have an opioid use disorder, and death rates due to opioid overdose have increased rapidly. Since 2010, the number of opioid overdose deaths has more than doubled, from more than 21,000 to more than 42,000 in 2016. The biggest increase has been related to the use of synthetic opioids.

Last month, a report from the US Centers for Disease Control and Prevention noted a rise in emergency department visits for opioid overdoses. From July 2016 through September 2017, opioid overdoses increased 30% in all parts of the United States, as reported by Medscape Medical News.

"To manage opioid addiction and prevent future overdoses, increased naloxone availability must occur in conjunction with expanded access to evidence-based treatment for opioid use disorder," the surgeon general said.

AMA Applauds Naloxone Advisory

The American Medical Association (AMA) is pleased with the surgeon general's advisory on naloxone. "The AMA Opioid Task Force has encouraged physicians to coprescribe naloxone for all patients at risk of overdose," Patrice A. Harris, MD, chair of the AMA Opioid Task Force, said in a statement.

"Surgeon General Adams, physicians, first responders, and public health advocates all recognize that naloxone is a literal lifesaver and a vital tool in our fight against the opioid epidemic. Patients, family members, and friends should not hesitate to ask their physicians to prescribe naloxone so they can save their own or their loved one's lives," Harris added.

"Many states have made naloxone available without a prescription. All forms of naloxone should be readily available and covered by insurance plans with minimal or no cost sharing. The AMA looks forward to working closely with the surgeon general's office to help bring an end to the epidemic of opioid overdose deaths," said Harris.

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