By Gabriella Dunn
The Wichita Eagle
WICHITA, Kan. — Kansas is one of three states that limits the availability of a life-saving drug that reverses opioid overdoses.
Right now, only certain health care professionals have the drug in Kansas.
But those who have the overdose-reversing drug often aren’t the first to arrive after someone calls 911 to report an overdose.
The drug is called naloxone, or Narcan by its brand name. Naloxone works as an antidote to opioids — including heroin and prescription painkillers, such as OxyContin, hydrocodone, codeine and fentanyl.
Researchers and medical professionals have widely recognized naloxone as a key way to slow the growth of overdose deaths, which have ballooned in recent years. Between 2002 and 2013, the rate of heroin-related overdose deaths in the U.S. nearly quadrupled, according to the Centers for Disease Control and Prevention.
Kansas might soon join the vast majority of the country in expanding access to naloxone. Some medical-related professionals hope to see a naloxone bill introduced in the upcoming legislative session, and the board that oversees emergency services in Kansas might widen the number of people who have the drug.
“Lives will be saved,” Malachi Winters, program manager for the Wichita/Sedgwick County EMS System, said about making naloxone more available.
Other states, cities
Residents in Kansas, Montana and Wyoming have the least access to naloxone. In Kansas, it is limited to paramedics and medical professionals. Emergency technicians, police and firefighters, who are often the first to respond to an emergency call, do not carry the drug.
“There’s a huge spectrum across states,” said John Gallagher, medical director of the Wichita/Sedgwick County EMS System. “There’s by no means uniformity.”
The CDC recommends all states expand access to naloxone.
Some states allows EMTs, first responders and law enforcement to carry the drug. Other states allow residents to buy naloxone from pharmacies with a prescription.
And some cities, like Baltimore, expanded access to all residents through blanket prescriptions. Lena Wen, health commissioner of Baltimore City, issued a standing order for every resident of Baltimore to have a prescription of naloxone, prescribed by Wen.
Wen concurrently helped pass malpractice laws so physicians won’t fear prosecution for prescribing naloxone.
The goal is for every resident to carry naloxone at all times, because the city became so plagued by heroin and opioid overdoses.
The blanket prescriptions allow any resident to receive a naloxone kit and education about how to use it.
“The reason we focused on it is because it’s very tangible,” Wen said.
“Modern medicine has many treatments and very few cures.”
Some question whether expanded naloxone access encourages drug use and enables addicts. Others worry that it may discourage those who have overdosed from seeking further medical treatment. The effects of naloxone are short lived, and the drug is meant to be used in addition to calling 911, not in place of it.
The drug is generally not harmful if taken by someone who is not overdosing on opioids.
How it works
Naloxone can be administered via an autoinjector, nasal spray or through an IV in a medical setting.
Lay people often receive an autoinjector or nasal spray.
The autoinjector works similarly to an Epipen, which is used for severe allergic reactions, but has audio instructions that play when someone opens the device.
Essentially, the person takes out the device, removes a tab at the bottom, places the autoinjector to the side of the thigh and pushes down. A needle punctures the person’s clothing and skin and injects medicine into their muscle mass.
Regulation changes
The Kansas Legislative Research Department said the state does not specifically forbid doctors from prescribing naloxone to patients, but the legalities, regulations and access issues about naloxone are ambiguous.
“The idea would be at least to potentially get something into statute regarding this greater concept,” said Gallagher of the Wichita/Sedgwick County EMS System.
Gallagher and a group of other stakeholders are discussing whether and how groups should pursue a naloxone-related bill for the upcoming legislative session.
One proposal the groups are considering would potentially expand access via prescriptions to people in the general public. The Kansas Medical Society legislative committee will discuss the proposal at its committee meeting on Nov. 29.
Gallagher is also part of a medical advisory council for the Kansas Board of Emergency Medical Services. The council, he said, may recommend on Dec. 2 that the board allow first responders and EMTs to use naloxone.
During an overdose, time is of the essence because of how quickly someone begins to die after taking too large of a dose of heroin or opioid painkillers.
The rate at which someone dies depends on how the person took the drug and the amount they took. Asphyxia causes the user to pass out and deprives them of oxygen. In some cases, heroin users will pass out with a needle still in their arm.
Many other people overdose, and die, by taking their prescribed amount of painkillers following a surgery, or to treat pain. Because of that, medical researchers have suggested naloxone be co-prescribed with all opioid medications.
“Who are the people that interact with the patient first?” Gallagher said. “In a lot of situations, it’s not a professional rescuer – it’s a family member. That in itself makes the family member a good place to put the medication, if you identify an at-risk population.”
Copyright 2016 The Wichita Eagle