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Better Opioid Rescue Drug Access Needed01/29 09:29

   

   ALBANY, Ga. (AP) -- Jessie Blanchard started small nearly five years ago, 
just trying to get enough of the rescue drug naloxone that reverses opioid 
overdoses to keep her daughter from dying from an overdose.

   She pleaded with colleagues at the college where she's an adjunct teacher in 
Albany, Georgia, to use their prescription benefits to get two doses every six 
months.

   Now she loads her Jeep every week and heads out with a few other volunteers 
to bring the antidote -- commonly known by its brand name Narcan -- to hundreds 
of others in the town of 70,000.

   At parking lots and intersections she also supplies clean needles, fentanyl 
test strips and a nonjudgmental sounding board -- an effort now partly funded 
by a state government grant. At least nine times in December alone, Blanchard 
said, rescue drugs she provided were used to reverse overdoses.

   "I've got story-after-story, story-after-story of people coming up to me," 
said Blanchard, a nurse whose organization is called 229 Safer Living Access, a 
reference to the Albany area code the group's work covers. "They say, 'Miss 
Jessie, they had to Narcan me the other day and I'd have died if it wasn't for 
you.'"

   Naloxone, available as a nasal spray and in an injectable form, is a key 
tool in the battle against a nationwide overdose crisis linked to the deaths of 
more than 100,000 people annually in the U.S. State and federal policy changes 
have removed some major obstacles to getting it into the hands of police, 
firefighters, people who use drugs and their loved ones. But it's still often 
frustratingly inaccessible in the moments when overdoses happen.

   Stephen Murray, an overdose survivor and former paramedic who researches 
overdoses at Boston Medical Center, is so committed to naloxone access that he 
proclaims it on his personalized license plate: NARCAN.

   "My vision for it is to be in every 24-hour gas station in the state, free 
or 25 cents a dose," he said. "It'll be between the Tylenol and the condoms. 
... It has to be just as easy as buying heroin, basically."

   There's more naloxone than ever thanks to federal and state policies, and 
groups like Blanchard's that distribute it in their communities. It's available 
free in old newspaper vending boxes in Michigan, which now hold naloxone kits, 
and in a vending machine in Philadelphia. One group, NEXT Distro, mails it 
nationwide for free. But Murray's vision is not close to being realized in most 
places.

   An influx of money is on the way, intended to help deal with the national 
overdose crisis that killed 107,000 people in 2021 -- the highest tally ever -- 
most involving fentanyl and other powerful illicit synthetic opioids.

   Drug makers, distribution companies and pharmacies have settled lawsuits 
with state and local governments, and the first funding totaling more than $50 
billion is going out. Most of it must be used to address the opioid epidemic, 
though exactly how will be up to governments receiving the money. Some 
settlements are being delivered partly in doses of naloxone.

   In a 2021 report, public health experts convened by the Johns Hopkins 
Bloomberg School of Public Health listed expanding naloxone access as the first 
strategy for using settlement funds, noting that 40% of overdose deaths happen 
when someone else is present and possibly able to administer the life-saving 
drug.

   As with other harm-reduction strategies, there's been pushback from those 
who believe making naloxone available enables drug use. But Jeff Breedlove, 
policy chief for the Georgia Council for Recovery, said he no longer sees that 
as much of an issue.

   Instead, he said, funding and distribution programs remain spotty because 
they don't have enough support from government and private groups such as 
chambers of commerce. "Until they treat it like an epidemic," Breedlove said, 
"we will continue to have more and more funerals."

   Since 2016, the federal government has allowed and encouraged federal funds 
to be used to buy naloxone.

   Officials in every state have given standing orders to pharmacies allowing 
people to buy it, even without prescriptions.

   That's a major factor for the massive increase in how much has been 
distributed through retail pharmacies. A report by the American Medical 
Association and IQVIA Institute for Human Data Science found there were just 
over 1,000 orders filled in 2012. By 2021, it was nearly 1.2 million.

   But not all pharmacies carry it. And it comes at a cost: For those without 
insurance coverage, it can be around $50 for two doses.

   The U.S. Food and Drug Administration is considering allowing some forms of 
naloxone to be sold over-the-counter without a prescription, a move that could 
lower the cost.

   Randy Anderson, who is in recovery himself and works as a recovery 
consultant, said he's handed out some 100,000 doses of naloxone in Minnesota. 
He believes from his time using drugs that pharmacy availability doesn't do 
much to help people who need it most.

   "There was no way I would spend $10 for something to save my life when I 
needed that money to buy drugs," he said.

   Aside from cost, there are other barriers to getting naloxone to drug users.

   In Alabama, for instance, a pharmacist, physician or public health nurse 
must be involved in the distribution. But the state does have a program to mail 
the antidote to anyone who requests it.

   Maya Doe-Simkins, a co-director of Remedy Alliance/For The People, which 
helps provide naloxone to groups working to prevent overdose deaths, said 
programs don't always prioritize getting the antidote to people who use drugs.

   "If they're not matched up and directed where they should be, we're going to 
see more and more naloxone sitting on the shelves of church basements, 
expiring," she said.

   Colin Dwyer, a former social entrepreneur-in-residence at the Stanford 
School of Business, founded the Overdose Crisis Response Fund to try to boost 
small distribution efforts across the country, including Blanchard's in Albany.

   "All I actually care about is what has the probability of saving the most 
lives the fastest," Dwyer said.

   One of his grantees, Talia Rogers, distributes naloxone and other supplies 
in Kirksville, Missouri, through a one-person operation, Show Me Harm 
Reduction, which she initially funded with money she made working as a nanny.

   She's now a consultant for the Missouri Institute of Mental Health and gets 
naloxone through the state's use of a federal grant.

   "If they're not getting Narcan or naloxone through me, they're not getting 
it," Rogers said.

   Ron Stewart, an emergency preparedness planner for Adair County, which 
includes Kirksville, said it provides naloxone only to first responders now, 
but he's hopeful a state program will soon make it available to the public, too.

   In Albany, Blanchard gets naloxone through Georgia Opioid Prevention, which 
receives a state grant.

   In 2022, she handed out more than 1,800 doses -- far more than the public 
health district for Southwest Georgia, which gave out 280 doses to people who 
showed up at health department offices in an isolated corner of Albany and to 
community organizations.

   One of her clients, who asked to be identified only by his first name, Jomo, 
because he uses illegal drugs, said he's glad for the supplies. "Because this 
is something we're going to do anyway," he said.

   Blanchard said 26 people have come to her group for help getting into 
treatment programs, and 19 are currently not using.

   She recalled her desperation in 2018, trying to help her daughter, then a 
teenager. Now 22, her daughter is still using.

   "She's so beautiful and so perfect," Blanchard said. "And because of harm 
reduction, she's still alive and she's healthy and she's thriving."

 
 
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