Narcan Is a Life-Saving Drug, yet Only 45% of PA Pharmacies Stock It

PUBLISHED JAN. 17, 2023

Since its FDA approval in 1971, Naloxone, more commonly known under the brand names Narcan and Kloxxado, has been an instrumental tool in reversing opioid overdoses for the last 50 years. The reason opioids are so dangerous when they are abused is that opioids block receptors in the brain, specifically the brain stem, that are necessary for bodily functions such as breathing. If too many of these receptors are blocked your nervous system and breathing become depressed and when too many are blocked it causes an overdose and shuts down your lung function completely. This is where Naloxone comes in to reverse the overdose's effects, specifically restoring regular function back to the lungs. There are multiple ways that Naloxone can be administered. There are intravenous and intramuscular methods of injecting Naloxone through IV or a needle, but the most common route of administration is intranasal. This is because Narcan, a commercial brand of Naloxone comes in a patented spray bottle for ease of use and portability, and requires no prior training to administer. This allows someone to have the ability to reverse an overdose anytime anywhere if they need to. Narcan nasal spray was FDA-approved in 2015 and became the first nasal spray approved for the treatment of an expected opioid overdose. The nasal spray device comes prepackaged and is ready to deliver a consistent 4mg dose of Naloxone as soon as you take it out of the box.

Naloxone is a life-saving medicine, so much so that in 2018 the Office of the Surgeon General called for increased distribution of the drug, and Pennsylvania issued standing orders in 2015 and updated in 2022 authorizing anyone to obtain naloxone. However, in PA the choice to stock up on the drug is left up to the pharmacies, and a recent study found that only 45% of PA pharmacies stock the drug (Holmes et al., 2022). While one may be able to argue that “Hey, this statistic makes sense. The only pharmacies that would be stocking up on Naloxone are pharmacies located in areas with higher rates of substance abuse, therefore more populated areas. It’s simple supply and demand.”. Now, this take is not unfounded and there is even data to back this up. As a study shows that in counties with lower populations, there were lower rates of accessibility to Naloxone products, around 45%-47%. It also found that in higher population counties like Philadelphia, it was far more accessible at around 97% accessibility (Holmes et al., 2022). Again, this makes sense because more people live in Philadelphia county so there are higher rates of addiction and there is a larger need for Narcan. Furthermore, if we were to continue along this logic we could assume that there would be higher rates of overdose in Philadelphia county as there are far more people using. However, this is where this line of thought runs into issues. The same study found that out of all deadly overdose cases in PA, 33% of victims lived in rural counties compared to the 28% that lived in most populated counties (Holmes et al., 2022). While we're unable to know the exact decision-making that these pharmacies make when deciding to stock up on a drug, we do know what the effects of this decision have been. This has led to many deaths caused by a lack of accessibility, and while pharmacies choosing to not stock Narcan is not the only factor that plays into accessibility, price and distance from the nearest pharmacy or hospital are two more, it is clear that this lack of access is helping no one and only contributing to more, potentially reversible, overdose deaths.

References

Holmes, L. M., Rishworth, A., & King, B. H. (2022). Disparities in opioid overdose survival and Naloxone administration in Pennsylvania. Drug and Alcohol Dependence, 238. https://doi.org/10.1016/j.drugalcdep.2022.109555