Washington, D.C. Mayor Muriel Bowser (D) plans to distribute 76,000 kits of naloxone, a drug used to counter opioid overdoses, to police officers and community health organizations by Sept. 30.
The purchase of 76,000 naloxone kits marks an increase in the city’s efforts toward overdose death prevention, as only 2,396 kits were distributed over the last nine months of 2017, where overdose deaths were at their peak, according to The Washington Post. In 2018, D.C. saw more deaths from opioid-related overdoses than homicides.
The distribution plan is a part of Bowser’s “LIVE. LONG. DC” initiative, which was released in December and aims to cut opioid related deaths in D.C. in half by 2020. An updated version of LIVE. LONG. DC, released March 28, includes more detailed procedures for D.C. institutions to begin carrying out the initiative.
The update was released after complaints made by D.C. officials stated that the original document was too vague and lacked specific details such as timelines, according to The Washington Post.
In addition to the distribution of naloxone, the update includes an April 30 deadline for the start of another program which allows recent overdose victims to be treated with buprenorphine, a medication that diminishes opioid cravings as part of long-term addiction treatment. MedStar Washington Hospital Center, United Medical Center and Howard University Hospital will implement the initiative first.
To receive input on the plan, the D.C. Council Judiciary and Public Safety and Health committees held a joint public oversight roundtable Jan. 28, where they received feedback from the public, the mayor’s office, the Department of Behavioral Health and the Metropolitan Police Department. The roundtable lasted for more than nine hours and covered topics such as street outreach to heroin users and the possibility of establishing government-supervised areas where residents can inject heroin, according to The Washington Post.
Opioid use and overdose prevention policies must treat addiction as a health issue, according to Regina LaBelle, program director at the O’Neill Institute for National and Global Health Law. The O’Neill Institute, which is housed at the Georgetown University Law Center, seeks to develop solutions to national and international health concerns such as the opioid epidemic.
“Recognizing that addiction is a disease from which people can recover, our drug policies must be centered around compassion,” LaBelle wrote in an email to The Hoya. “Providing naloxone to community members and first responders is an important tool to save lives.”
LaBelle, who is also the former chief of staff of the White House Office of National Drug Control Policy, responded to potential opposition to the initiative in a testimony presented at the roundtable. The number of opioid-involved overdose deaths in the District more than tripled from 2014 to 2017. The uptick in overdoses occurred despite emergency medical responders providing residents with prompt services, according to LaBelle.
“It continues to be important, therefore, to get naloxone into the hands of as many people as possible, including law enforcement and community groups such as syringe exchange programs,” LaBelle said during the testimony.
The Metropolitan Police Department and Bowser’s office initially perceived the initiative as expensive. However, costs of naloxone can vary and manufacturers of the product have already put in place programs to make the drug more accessible for purchase by the government, according to US News.
The cost of naloxone varies from $12 generic injectable doses to a $150 nasal spray containing two doses, according to LaBelle. Manufacturers of the most expensive naloxone product, the auto-injector, announced that by mid-2019, their product would be available for purchase to government agencies for $178, significantly less than the usual retail cost of $4,100.50, according to LaBelle.
Other objections to the widespread distribution of naloxone among law enforcement and community healthcare centers included potential criminal liabilities. However, good samaritan laws and laws designed to protect healthcare professionals have been established in many states to protect those who administer the drug, according to the United States Surgeon General Jerome Adams.
Citizens can also play a role in administering the drug to prevent overdose deaths, according to to Adams. There are two FDA-approved naloxone products for community use that are available by prescription.
Too few community members are aware of the drug’s accessibility, Adams wrote in a 2018 Naloxone Advisory Statement.
“Expanding the awareness and availability of this medication is a key part of the public health response to the opioid epidemic” Adams wrote. “Therefore, increasing the availability and targeted distribution of naloxone is a critical component of our efforts to reduce opioid-related overdose deaths and, when combined with the availability of effective treatment, to ending the opioid epidemic.”
Research suggests that an effective measure to decrease overdose deaths in a community is to provide naloxone and overdose education to its members, according to Adam’s statement.
To further increase the drug’s accessibility, the FDA is currently developing an over-the-counter version of the drug, available for purchase by the public. People who are or who know someone at risk for opioid overdose can already go to a pharmacy or community-based program to receive naloxone and naloxone administration training without a patient-specific prescription, according to Adams.