Fla. nonprofit sends double-strength naloxone to downtown Orlando as overdoses rise

The FDA says Kloxxado Nasal Spray may lead to opioid withdrawal symptoms in those who are dependent and for laypeople to call 911 when they use it


By Caroline Catherman
Orlando Sentinel

ORLANDO — As powerful synthetic opioids like fentanyl continue to drive overdose deaths in Central Florida, traditional overdose-reversal methods aren’t working anymore.

Naloxone, sold under the brand name Narcan, has been used for years to temporarily reduce the effects of opioid overdoses, restoring breathing and consciousness to an unconscious person within minutes. It can be injected or used as a nasal spray.

"Rainbow fentanyl" pills are designed to look like candy. (Photo/Multnomah County Sheriff's Office Facebook)

However, synthetic opioids are so powerful that a single naloxone dose sometimes isn’t enough, the Centers for Disease Control and Prevention reports. Fentanyl is 50 to 100 times more potent than morphine, for example.

Fentanyl overdoses are now the top cause of death among U.S. residents ages 18-45, surpassing suicide and car accidents, according to an analysis of federal data by opioid awareness organization Families Against Fentanyl.

“Overdoses are becoming more and more dangerous, it seems like, every single month,” said Andrae Bailey, founder and CEO of the Orlando-based nonprofit Project Opioid. “The drug crisis of five, 10 years ago is not the drug crisis of today.”

Project Opioid is fighting back, sharing a drug two times the strength of Narcan: Kloxxado Nasal Spray.

Naloxone has been approved to treat overdoses since 1971 by the Food and Drug Administration. The drug is very safe, even for children, its website notes, and Kloxxado is no different. The spray is designed to be used at home without any medical training.

The drug reverses opioid overdoses, so it’s not dangerous to have it in the hands of the general public, Bailey said.

The Food and Drug Administration notes that the drug will not help with overdoses on non-opioids. In addition, it may lead to opioid withdrawal symptoms in those who are dependent on the drug, which is why it’s crucial to call 911 alongside its use, a news release reads.

Project Opioid met with leaders of Orlando downtown’s top restaurants and bars on Wednesday, where members distributed the nasal spray and provided a digital harm reduction employer toolkit and naloxone training.

The initiative is dubbed the Downtown Overdose Reversal and Intervention Program (DRIP).

“Downtown is the epicenter for our nightlife, and unfortunately the same can often be said of our drug scene,” Bailey said in a news release.

Bailey said part of the reason he chose downtown Orlando is because this is where young people from throughout the region gather every weekend.

Project Opioid was founded in 2018 by Bailey in response to the opioid crisis. It conducts research and community needs assessments that are used by local leaders to form policy. The project provides wide-scale education and outreach throughout the nation.

Wednesday’s meeting reinforced the message that Project Opioid has tried to drive home since its creation: few escape from the opioid crisis untouched.

“These bar owners, restaurants owners downtown, they’re seeing this crisis,” Bailey said. “Seemingly everyone knew someone that had overdosed, or that had died, or had friends, family members that had died.”

Project Opioid will continue to distribute Kloxxado to downtown Orlando business owners for the next several months, Bailey said.

Over 5,000 units of this drug, approved by the Food and Drug Administration last year, were donated to Project Opioid by Hikma Pharmaceuticals, the drug’s manufacturer. This donation is valued at more than $300,000.

Connecting with downtown business owners is just the first step, Bailey said. Project Opioid plans to ensure law enforcement has access to this more-powerful form of Narcan as well in the coming months. Cities throughout Florida and the U.S. have expressed interest, too, Bailey added.

Overdose deaths in Orange, Osceola and Seminole counties rose 28% from March 2020 to March 2021, according to a November 2021 report by Project Opioid.

In addition, Florida Department of Health offices statewide including in Orange, Osceola, Lake and Seminole Counties have announced in the last week that they are now providing free Narcan kits for pickup at some of their offices, no appointments necessary.

Some who overdose on fentanyl don’t even know they’ve taken it, or even that they’ve taken an opioid at all. It can be mixed with cocaine, heroin, or methamphetamine, or made into pills that resemble other drugs, the CDC reports.

Symptoms of an opioid overdose include pinpoint pupils, loss of consciousness, slow or no breathing, choking or gurgling sounds, cold or discolored skin, particularly lips or nails, and a limp body. If an overdose is witnessed, a person should call 911 immediately along with administering Narcan, FDOH says.

The FDOH kits are limited to people over 18 at risk of an opioid overdose or at risk of witnessing an opioid overdose, news releases say.

These efforts come on top of the recent news that Central Florida will see nearly $15 million from an estimated $13.1 billion settlement from lawsuits against the nation’s largest pharmacies for their role in the opioid crisis. Some of the funds will be used to combat opioid overdoses.

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