National pharmacy giant CVS said this week that naloxone — a quick-acting antidote to overdoses from heroin and other opioids — will be available without an individual prescription in all 132 of its Louisiana pharmacies by early June.
The Rhode Island-based company said the move in Louisiana is part of an effort to broaden access to the lifesaving drug in seven states by early August, making naloxone more easily available from CVS stores in 30 states in all.
The company said it is moving to address the nation’s rising opioid addiction and overdose problems.
Naloxone, which is available now at CVS and at other pharmacies with a doctor’s prescription, has been used for years in emergency rooms and is spreading among first-responders, but Louisiana public health advocates and some in the medical community have argued that broadening access can be a lifesaving option for heroin and other drug addicts reluctant to consult a physician.
“The long and short of it is people are dying. It’s unfortunate that we’re to this point in our society, but it’s something that is needed,” said Dr. Jon “Michael” Cuba, an emergency room physician at Ochsner Medical Center in Baton Rouge.
He said he believes heroin overdoses are continuing to rise in Baton Rouge and that the problem cuts across all sectors of society.
Cuba, president-elect of the Louisiana chapter of the American College of Emergency Physicians, added he has seen people be so bold as to drop off someone who is overdosing at the emergency room door and then drive off, apparently fearful they may get in trouble.
Between 1999 and 2014, deaths from prescription opioids, such as oxycodone and hydrocodone, have quadrupled nationally, killing more than 14,000 in 2014, the U.S. Centers for Disease Control and Prevention says. At the same time, sales of prescription drugs have quadrupled. Meanwhile, overdose deaths from heroin, an illegal opioid, also have nearly quadrupled between 2002 and 2013, killing more than 8,200 in 2013, the CDC says.
The U.S. Food and Drug Administration says naloxone counters the potentially deadly slowed breathing, extreme drowsiness and lost consciousness from an opioid overdose in as little as two minutes.
Naloxone, which goes by the brand name Narcan, won’t be available over the counter at CVS but will remain with the pharmacist.
CVS’ announcement Wednesday comes a few months after Walgreens, CVS’ national rival, said Feb. 9 that it will offer naloxone without an individual prescription in 35 states.
Phil Caruso, Walgreens spokesman, said Thursday the company is still working on the regulatory steps to offer naloxone in Louisiana but expects to have it available in Walgreens’ 157 pharmacies in the state without an individual prescription by the end of the year.
Erin Britt, CVS spokeswoman, said naloxone will be available at CVS stores in a nasal spray and through an intramuscular injector similar to the EpiPen injector used to counteract severe allergic reactions. The FDA approved the nasal spray Nov. 18 after fast-tracking its review.
The cash price for the nasal spray at CVS will be $90, while the injector will cost $45. Both options will come with two doses, Britt said.
Walgreens offers both the nasal spray and intramuscular injector for $78 on a cash basis under store savings club prices, Caruso said.
Customers at CVS and Walgreens will have to ask for the drug from a pharmacist and receive some counseling about how to administer it and provide care to the person overdosing while emergency responders arrive.
The FDA considers naloxone a prescription drug and has not approved it for over-the-counter use, CVS and Walgreens representatives said. But last year, the Louisiana Legislature passed House Bill 210, which allows pharmacies to work with doctors to issue a standing order to dispense naloxone so physicians aren’t required to examine a person for a naloxone prescription.
The law, which took effect Aug. 1, also limits doctors’ and pharmacists’ civil and criminal liability for prescribing and dispensing naloxone, and it protects pharmacists from professional discipline for dispensing the antidote.
Britt and Caruso, the CVS and Walgreens representatives, respectively, said the law allowing the issuance of the standing order cleared the way for the national pharmacies to provide naloxone without an individual prescription.
East Baton Rouge Parish Coroner William “Beau” Clark, who has been outspoken about Baton Rouge’s rising number of heroin overdoses, said the expanded availability of naloxone will save lives but suggests more needs to be done to attack the root problem.
“If you don’t treat your addiction, you’re kind of kicking the can down road, and I think that’s why we have to look at curing the opioid epidemic in the country,” Clark said.
He said the state and nation need to make it harder to sell illegal drugs like heroin, need to get a better handle on how and when legal drugs are prescribed and need to invest more in mental health programs so people with addiction or underlying mental health problems can get treatment.
Clark said wider availability of naloxone also could mean an increase in mental health commitments as survivors are sent for drug treatment.
But, as he tells people he has committed, he’d rather be committing them than investigating their death.
No Overdose Baton Rouge, a grass-roots group, supplies naloxone to a program in north Baton Rouge so it can offer the antidote once a week.
But Logan Kinamore, executive director of the group, said more state and federal funding is needed to make naloxone more affordable to people from lower socioeconomic groups.
“The way we look at it, the more points of access to naloxone, the easier it is for people to get it, the better off we all are,” Kinamore said.
Follow David J. Mitchell on Twitter, @NewsieDave.