(Baltimore) – On a corner of Baltimore Street, public health workers deliver an overdose antidote to save lives for residents who painfully know the ravages of the opiate epidemic in the United States. U.S. But the training ends quickly; all naloxone inhalers are claimed in 20 minutes.
"We could have delivered hundreds of doses today, but we only had 24 kits, that goes fast," said Kelleigh Eastman, a health department worker who helps the city bluntly. called "Do not Die" campaign against overdose.
Cities like Baltimore feel financial pressure, as they depend on naloxone to try to counteract the rising rates of overdose. Some very affected communities across the country are struggling to pay the doses, even at reduced prices.
With more overdoses driven by synthetic opioids such as fentanyl and carfentanil, so powerful that it is used as a tranquilizer for elephants, naloxone is still rich enough for the Baltimore Department of Health is rationing supplies, stretching a decreasing reserve of inhalers. Last year, the city distributed more than 25,000 doses, compared to approximately 19,000 in 2016.
"Each week, we count the doses that remain and make difficult decisions about who will receive the medication and who will have to do without," said Baltimore's health commissioner, Dr. Leana Wen, who issued the city's innovative general recipe for the drug in 2015.
Since then, numerous states have passed laws that include bypassing prescription requirements and establishing programs of community training. the medicine that restores a person's breathing while temporarily blocking opioid receptors in the brain.
"It's a bit of a pressure cooker environment for Baltimore but also places in many other states that have been at the forefront of the overdose crisis and where the challenge, structurally, is that there is no source of Clear sustainable financing for naloxone, "according to Daniel Raymond, Nationa's policy director. l Harm Reduction Coalition.
In Charleston, West Virginia, the health department reported Monday that it only has 159 doses left, most assigned to community classes in the coming days. The spokesman for the Health Department of Kanawha-Charlestown, John Law, said that they requested more naloxone auto-injectors from the company that donated them in the past "but we have not had an answer".
On this Thursday, September 17, 2015, photo, used heroin syringes and kitchen spoons are hidden at the base of the trees when Steve Monnin cleans a wooded area of Combs Park in Hamilton , Ohio. The Centers for Disease Control and Prevention has called the use of heroin a national epidemic and is hitting heavily in southern Ohio. (AP Photo / John Minchillo)
Last week, the US Surgeon General UU Dr. Jerome Adams issued the first national public health notice of the office in 13 years, asking more Americans to start taking naloxone and urging more federal funds to increase antidote access.
"The costs should not and, in the near future, they will not be a barrier to accessing naloxone for anyone in the United States," Adams promised.
A two-dose box of Narcan – a brand for naloxone inhalers: has list prices of approximately $ 125. First responders and community organizations can buy Narcan with discounts of $ 75 per box of two doses, depending on the manufacturer Adapt Pharma. The Evzio autoinjector from the Virginia-based pharmacy Kaleo currently has list prices of approximately $ 3,800 per box with two doses, up from $ 690 in 2014.
The surgeon general's advice was welcomed in Philadelphia, where Health authorities discussed internally whether "rationing" accurately describes their naloxone status. The city has one of the highest opiate mortality rates of any major US metropolis. UU And distributed 25,000 doses from July to December last year.
"Given the tremendous extent of the opiate epidemic and (ours) 1,200 overdose deaths were anticipated in 2017, easier – and cheaper – access to naloxone for the general public and public safety agencies has the potential to save hundreds of lives, "said Philadelphia Department of Health spokesman James Garrow.
What is at stake could not be more. Growing anecdotal evidence shows that multiple doses of naloxone are needed to reverse an overdose caused by synthetic opioids, rather than the single dose to reverse an overdose of heroin.
Baltimore Fire Deputy Chief Mark Fletcher said first responders have found that "two doses" or maybe even three doses "are needed to restore breathing if a person used heroin mixed with fentanyl or carfentanil."
] It is still unclear how naloxone saturation is affecting deaths from overdoses in general.A study from 2017 published by the National Bureau of Economic Research suggests that laws that increase access to naloxone are related to up to 11 per One hundred deaths.
In a gritty Baltimore neighborhood, Shane Shortt, a heroin addict, said he's been able to revive five drug buddies with Narcan over the past year and swears he never goes anywhere without an inhaler.
"You never know when you're going to have to use it. It was actually used on me like last week, "Shortt said outside a needle-change van in Baltimore where a dozen people show the ravages of long-term drug use aligned with some younger people.
addiction and recovery expert with the National Council on Behavioral Health, Tom Hill, said the conclusion is that naloxone is just "all we have" to fight overdoses.
"Anything to reduce the costs of a drug That saves lives is something very welcome, "he said from Washington.
Wen, who is among the many officials ca He called the Trump administration to directly negotiate the price of naloxone with the manufacturers, was more blunt:" We are in the midst of a national epidemic. We should not have a price beyond the capacity to save lives. "