The Akron Legal News

Bill would expand access to antidote for drug overdoses

TIFFANY L. PARKS
Special to the Legal News
Published: May 6, 2015

A bill that would expand statewide access to what has been tagged as a “miracle drug” for reversing drug overdoses has gained a wave of support from the medical community.

“State policymakers and stakeholders, including the Ohio State Medical Association, have made real progress in combating Ohio’s epidemic of prescription drug abuse, misuse and diversion,” said Marisa Weisel, OSMA manager of advocacy and policy.

“We have worked together to tackle this issue from multiple angles, and the legislation, regulations, guidelines and education campaigns that we have all put into place are making a difference. We know that the number of prescriptions written for opioid painkillers is decreasing, and we know the average strength of these prescriptions as measured by morphine equivalent dose, or MED, is also decreasing.”

As a result, Ohio’s rate of unintentional drug poisoning from prescription drugs is falling.

Unfortunately, Weisel said, the number of unintentional heroin overdose deaths is on the rise.

“Thankfully, there is a lifesaving drug that can be given to individuals who are experiencing an overdose,” she said.

“Most patients who are given naloxone when overdosing on opioids respond by returning to spontaneous breathing within three to five minutes. Naloxone has no potential for abuse, and it serves a single function: to prevent death by reversing opioid overdoses.”

House Bill 4, sponsored by Reps. Robert Sprague, R-Findlay, and Jeffrey Rezabek, R-Dayton, would allow a physician to authorize an individual to furnish naloxone pursuant to the physician’s protocol to a person at risk of an opioid-related overdose or to another person in a position to assist that person.

The bill, which unanimously passed the House and is now before the Senate Health and Human Services Committee, would require the Ohio Department of Health to develop a model protocol regarding the dispensing of naloxone without a prescription by one or more pharmacists or pharmacy interns and authorizes a local board of health to establish a naloxone protocol no less stringent than the model.

“Last session, House Bill 170 took a step toward preventing overdose deaths by allowing prescribers to personally furnish or give a prescription for naloxone to a friend, family member or other individual in a position to provide assistance to those at risk of experiencing an opioid-related overdose,” Weisel said.

“Our physicians believe it is time to build upon HB 170’s success. HB 4 would take the next step by allowing individuals who are not authorized to prescribe drugs, including pharmacists and pharmacy interns, to personally furnish or dispense naloxone to anyone who could be in the position to help someone who is overdosing.”

The proposed legislation offers liability protections to those acting in good faith pursuant to the bill’s provisions, including the authorizing physician, the authorized individual who furnishes naloxone and those who receive naloxone and use it to assist a person at risk of an opioid-related overdose.

Rose Pavlakos, a licensed pharmacist in both the state of New Mexico and Ohio, said lawmakers in New Mexico passed legislation similar to HB 4 in 2002.

“A common misconception has been that by providing our patients with naloxone, we are allowing them to feel more comfortable abusing opioids,” she said.

“I can tell you from my experience, it is not the drug dealers or heroin addicts themselves that are typically requesting these products, but rather a mother, father, brother, sister and other family members or friends that approach us for help.”

Pavlakos went on to say pharmacists are in an ideal position to provide a safe health measure to the public and “do what is best for our patients to prevent harm.”

In addition to Weisel and Pavlakos, Joan Papp, a MetroHealth Medical Center emergency physician, also endorsed HB 4.

“In 2012, the Ohio Department of Health reported that 1,914 deaths occurred by unintentional drug overdose statewide or nearly five deaths every single day. This is the highest recorded number of overdose deaths in the history of our state,” said Papp, who is also the medical director of Cuyahoga County Project DAWN or Deaths Avoided with Naloxone.

“In Cuyahoga County and across our state, the epidemic that started with prescription opioids has evolved into a heroin epidemic. In the emergency department, my colleagues and I are on the front lines ... overdose victims are often dropped off on our front doors unresponsive, appearing lifeless and blue.”

Papp said naloxone has saved lives.

“It is an extremely safe and effective antidote to reverse opioid overdose and rapidly restore breathing to an overdose victim. Although naloxone is a prescription drug, it is not a controlled substance and has no abuse potential,” she said.

Since the enactment of HB 170 in the last legislature, Papp said officers in more than 20 Ohio police departments have begun carrying naloxone and 20 communities are currently operating naloxone distribution programs.

In addition, all six regional state psychiatric hospitals distribute naloxone to their at-risk patients and seven hospital-based programs are now distributing naloxone.

“Although we have achieved encouraging results, we must remain vigilant if we are going to succeed in the fight against a growing epidemic. Leveling off mortality is not enough, we need to see a reduction in mortality because losing five Ohioans every day to this epidemic is not acceptable,” Papp said.

“To do this, we need to increase the number of naloxone distribution sites statewide, expand our local program by increasing our distribution days and hours of operation and make naloxone available in settings that are currently not allowed.”

As of February 2015, Papp said 28 states have enacted legislation to increase access to naloxone.

“Passage of HB 4 is the next step to building on the work of Project DAWN in Ohio,” she said.

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