Rx Summit 18: Surgeon general underlines value of naloxone

Public health officials agree that administering naloxone is one of the more immediate solutions for saving lives in the addiction crisis. At the 2018 National Rx Drug Abuse & Heroin Summit, Surgeon General Jerome Adams, MD, underscored the strategy with a rare public health advisory issued from his office.

“If there is one takeaway I can leave you with it’s this: If you or someone you know is at risk for an overdose, carry and know how to use naloxone,” Adams said to the Rx Summit audience. “It’s an easy to use, life-saving medication that can reverse the effects of an overdose.”

He directly addressed the perception some Americans have that naloxone rescue presents a moral hazard, somehow encouraging substance use. By comparison, he said, no surgeon would ever refuse to save the life of a trauma patient who was injured in an automobile accident while speeding.

“What is the moral hazard of letting someone else’s child die of overdose when you know you could stop it?” Adams said.

In his travels across the country, he’s met numerous people in recovery and has seen how naloxone gave many of them a second chance.

“If that’s enabling, then call me an enabler,” Adams said.

Cost barriers

However, beyond the stigma, the more practical issue related to increased naloxone use is the cost. Because most individuals who overdose do so at home, it’s important that bystanders have access to naloxone in addition to first responders.

Adams said federal officials are working with pharmaceutical manufacturers now to make sure the drug is available at low or no cost to anyone who needs it—including the more costly autoinjector. Direct federal funding for naloxone access has increased in the president’s budget from $24 million in fiscal year 2017, to $48 million, then again to $75 million for fiscal year 2019. Adams said the president agrees that cost should not be a barrier for anyone.

“We will not spend our way out of this crisis, but we do need to figure out how we pay for the band-aids and tourniquets in the meantime,” he said.

His office is implementing a three-point strategy: prevention; education; and naloxone awareness, access and training. Adams discussed a number of other priorities such as drug take-back efforts, recovery coaching and housing and employment for those in recovery.

The last surgeon general advisory was issued in 2005 to warn pregnant women about the dangers of alcohol use.