In order to help fight the heroin epidemic in the northeast United States, Kroger supermarkets and CVS pharmacies will carry the anti-overdose (opioid antagonist) drug naloxone (trade name: Narcan) over the counter:
Ohio-based grocery chain Kroger Co. said Friday it will make the overdose-reversal drug naloxone available without a prescription in its pharmacies across Ohio and northern Kentucky, a region hard-hit by deadly heroin. Kroger said more than 200 of its pharmacies will offer naloxone over the counter within days. "We want families dealing with addiction to know that they can count on having the drug available in the event that they need it," Jeff Talbot, Kroger vice president of merchandising, said in a statement.
Ohio fire crews and other first responders use naloxone thousands of times a year to revive opioid overdose victims. Ohio overdose deaths jumped 18 percent in 2014, one of the nation's sharpest increases. Those on the front lines of the battle against heroin's spread have increasingly supported allowing and educating families and friends of addicts to administer naloxone in emergencies.
State regulators in Ohio and Kentucky have allowed the drug to be sold over the counter. Ohio Attorney General Mike DeWine and U.S. Sen. Rob Portman, R-Ohio, joined Kroger officials at a Cincinnati grocery store for the retailer's announcement. Portman has been pushing a multi-pronged heroin bill in the Senate that includes expanded availability of naloxone. "This marks an important step in our fight to combat addiction and we all need to continue to work for a bottom-up, comprehensive approach to the heroin epidemic," Portman, from the Cincinnati area, said in a statement.
CVS said recently it will soon offer naloxone without a prescription at its Ohio pharmacies.
Naloxone became available over the counter in Australia on February 1.
In the U.S., there are currently a patchwork of state laws which govern access to Naloxone.
In the U.K. as of 1 October, 2015, "...[A]ny worker in a commissioned drug service can now distribute naloxone without prescription."
Related: Alarming Rise in Death Rates for Middle-Aged White Americans
Related Stories
The White House announced a new Heroin Response Strategy on Monday to combat a "heroin/opioid epidemic" across 15 states in the northeast:
The Office of National Drug Control Policy said it would spend $2.5 million to hire public safety and public health coordinators in five areas in an attempt to focus on the treatment, rather than the punishment, of addicts. The funding — a sliver of the $25.1 billion that the government spends every year to combat drug use — will help create a new "heroin response strategy" aimed at confronting the increase in use of the drug. A recent study by the Centers for Disease Control and Prevention found that heroin-related deaths had nearly quadrupled between 2002 and 2013.
[...] Once thought of as a drug used only by hard-core addicts, heroin has infiltrated many communities, largely because of its easy availability and its low price, officials said. The problem has become especially severe in New England, where officials have called for a renewed effort to confront it. Gov. Peter Shumlin of Vermont devoted his entire State of the State Message in January to what he called "a full-blown heroin crisis" in his state. Like the new White House effort, the governor called for a new, treatment-based approach to the drug.
[More after the break...]
Gina Kolata reports at The New York Times that something startling is happening to middle-aged white Americans. Unlike every other age group, unlike every other racial and ethnic group, unlike their counterparts in other rich countries, death rates in this group have been rising, not falling, primarily because of the declining health and fortunes of poorly educated American whites who are dying at such a high rate that they are increasing the death rate for the entire group of middle-aged white Americans. "It is difficult to find modern settings with survival losses of this magnitude," say Ellen Meara and Jonathan S. Skinner.
Though not fully understood, the increased deaths are largely thought to be a result of more suicides and the misuse of drugs and alcohol, driven by easier access to powerful prescription painkillers, cheaper high quality heroin and greater financial stresses. Death rates for people with a high school education or less rose by 22 percent while they actually fell for those with a college education. The rise in death rates among middle-aged white Americans means half a million more people have died in the US since 1998 than if the previous trend had continued. The death toll is comparable to the 650,000 Americans who lost their lives during the Aids epidemic from 1981 to the middle of this year, the researchers say. Anne Case and Angus Deaton warn that middle-aged Americans who are turning to drink and drugs are set to suffer more health problems than their elders unless the downwards trend can be halted. "This is not automatic. If the epidemic is brought under control, its survivors may have a healthy old age. However, addictions are hard to treat and pain is hard to control, so those currently in midlife may be a 'lost generation' whose future is less bright than those who preceded them."
takyon writes:
It's that time of the year again. Time to talk about drugs and the war on them because some stoners declared a holiday or something.
A recent article in Harper's Magazine includes the following gem that sums up the modern Drug War's origins. The journalist interviewed John Ehrlichman, one of the Watergate co-conspirators:
At the time, I was writing a book about the politics of drug prohibition. I started to ask Ehrlichman a series of earnest, wonky questions that he impatiently waved away. "You want to know what this was really all about?" he asked with the bluntness of a man who, after public disgrace and a stretch in federal prison, had little left to protect. "The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I'm saying? We knew we couldn't make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did."
[Oh yes, it continues...]
NPR is reporting on the latest drug scare, involving an over-the-counter antidiarrheal drug that is being used for its opioid-like effects by addicts:
Some people addicted to oxycodone and other opioids are now turning to widely available diarrhea medications to manage their withdrawal symptoms or get high. The results can be dangerous to the heart — and sometimes fatal — warn toxicologists in a study [open, DOI: 10.1016/j.annemergmed.2016.03.047] recently published online in the Annals of Emergency Medicine.
The researchers describe two case studies where people who were addicted to opioids tried to ease their withdrawal symptoms by taking many times the recommended dose of loperamide, a drug commonly used treat diarrhea. Both patients died.
"Because of its low cost, ease of accessibility and legal status, it's a drug that is very, very ripe for abuse," says lead author William Eggleston, a doctor of pharmacy and fellow in clinical toxicology at the Upstate New York Poison Center, which is affiliated with SUNY Upstate Medical University.
Related:
Kroger Supermarkets to Carry Naloxone Without a Prescription
4/20: Half-Baked Headline
The Obama administration is loosening restrictions on buprenorphine/Suboxone prescriptions in order to fight the "heroin epidemic", while calling on Congress to act on a request for $1.1 billion in additional funding for opioid treatment programs across the U.S.:
The Obama administration is making it easier for people addicted to opioids to get treatment. Health and Human Services Secretary Sylvia Burwell announced new rules Wednesday to loosen restrictions on doctors who treat people addicted to heroin and opioid painkillers with the medication buprenorphine. Doctors who are licensed to prescribe the drug, which is sold mostly under the brand name Suboxone, will be allowed to treat as many as 275 patients a year. That's almost triple the current limit of 100, and HHS estimated that as many as 70,000 more people may have access to the drug as a result.
"There are a number of ways we are trying to increase access to medication-assisted treatment," said Michael Botticelli, the director of national drug control policy, on a conference call with reporters. "This rule itself expands access and gets more physicians to reach more patients."
Suboxone is itself an opioid. It eases withdrawal symptoms and cravings, but doesn't make people high. [...] Botticelli said an average 129 people a day die from opioid overdoses.
Here is some basic information about the differences between buprenorphine (Suboxone) and Naloxone (Narcan).
Previously:
White House Announces Heroin Response Strategy for the US Northeast
Alarming Rise in Death Rates for Middle-Aged White Americans
Kroger Supermarkets to Carry Naloxone Without a Prescription
4/20: Half-Baked Headline
The Cook County Jail in Chicago, IL has trained hundreds of inmates on how to use the opioid overdose-reversing drug naloxone, and has given doses out to inmates upon release:
Cook County now gives at-risk inmates the overdose-reversing drug naloxone upon their release from jail and Los Angeles is poised to follow suit, putting the antidote in as many hands as possible as part of a multifaceted approach to combatting the nation's opioid epidemic.
Cook County Jail, the largest single-site jail in the country, has trained about 900 inmates how to use naloxone nasal spray devices since last summer and has distributed 400 of them to at-risk men and women as they got out. The devices can undo the effects of an opiate overdose almost immediately and are identical to those used by officers in many of the country's law enforcement agencies.
[...] It is too soon to gauge the effectiveness of Cook County's program, but Dart said anecdotal evidence suggests that the kits have saved lives, including a man who was arrested again, returned to jail, and told of how a friend he had trained to use the kit had done so when he overdosed. In New York City, more than 4,000 kits have been distributed to friends and relatives of inmates at the city's jail at Rikers Island since the program there was launched in 2014.
Related: Kroger Supermarkets to Carry Naloxone Without a Prescription
Obama Administration Expands Access to Suboxone Treatment
One Upside to Opioid Overdoses: More Organ Donors
Development of a Heroin Vaccine
U.S. Surgeon General Jerome Adams has urged more Americans to carry the opioid overdose reversal treatment naloxone, known under brand names such as Narcan and Evzio. However, the drug and its delivery systems have become more expensive in recent years:
As opioid-related deaths have continued to climb, naloxone, a drug that can reverse overdoses, has become an important part of the public health response. When people overdosing struggle to breathe, naloxone can restore normal breathing and save their lives. But the drug has to be given quickly.
On Thursday, U.S. Surgeon General Jerome Adams issued an advisory that encouraged more people to routinely carry naloxone. "The call to action is to recognize if you're at risk," he tells Morning Edition's Rachel Martin. "And if you or a loved one are at risk, keep within reach, know how to use naloxone."
[...] The medicine is now available at retail pharmacies in most states without a prescription. Between 2013 and 2015, researchers found a tenfold increase in naloxone sold by retail pharmacies in the U.S. But prices have increased along with demand. Naloxone-filled syringes that used to cost $6 apiece now cost $30 and up. A two-pack of naloxone nasal spray can cost $135 or more. And a two-pack of automatic naloxone injectors runs more than $3,700. And while it's true that naloxone can prevent many opioid-related deaths, it doesn't solve the root cause of the problem.
Related: Kroger Supermarkets to Carry Naloxone Without a Prescription
Chicago Jail Handing Out Naloxone to Inmates Upon Release
Opioid Crisis Official; Insys Therapeutics Billionaire Founder Charged; Walgreens Stocks Narcan
(Score: -1, Troll) by Anonymous Coward on Saturday February 13 2016, @02:40PM
Woohoo! Now we don't need to care and can overdose safely just for a modest fee!
(Score: 0, Redundant) by Anonymous Coward on Saturday February 13 2016, @03:09PM
1) This is great
2) Over the counter ey? That's what's surprising to me about this. I didn't know narcan was OTC
(Score: 2) by EvilSS on Sunday February 14 2016, @12:52AM
It's not, exactly. States have started to change their laws to allow it to be distributed that way in some cases. In others, you can get an Rx for it, and the state shields the doctor from any liability resulting from the prescription. That means it's easy for doctors working with public health services to hand out prescriptions for it to users or their families.
(Score: 1, Informative) by Anonymous Coward on Saturday February 13 2016, @03:27PM
Most people are dying from the effects of NAPQI because of the acetaminophen that is invariably included with their codeine/oxycodone. Naloxone won't change that one bit. Bureaucracy gone mad when a solution is provided for the wrong problem. People who OD on actual opioids like heroin/morphine are in a rather small group, comparatively.
(Score: 0, Informative) by Anonymous Coward on Saturday February 13 2016, @04:08PM
"People who OD on actual opioids like heroin/morphine are in a rather small group, comparatively."
You have no idea what you're talking about.
(Score: 2, Informative) by Anonymous Coward on Saturday February 13 2016, @09:46PM
2014 Data Detailing Drug-Induced Deaths,
Breaking Out Specific Data for Prescription Analgesics and Heroin,
as Reported by the CDC:
Drug Overdose Total 47,055
Prescription Analgesics Total 18,893
Heroin Overdose Total 10,574
Source: CDC/NCHS, National Vital Statistics System, Mortality File, 2015, last accessed Dec. 11, 2015.
Prescription pain medication almost twice as much as heroin. It isn't the opioid component that kills you in prescription pain medication, it's the acetaminophen. So hey, you have no idea what you're talking about.
(Score: 2, Interesting) by Anonymous Coward on Saturday February 13 2016, @05:34PM
Yes, all officially produced opioids in the US are intentionally poisoned one way or another supposedly to reduce addiction.
(Score: 2) by Daiv on Monday February 15 2016, @02:38PM
So it's the "wrong problem" because it won't save everyone? If it saves one person, isn't that enough reason to make it accessible? I don't understand who or what is put out, by giving one more option.
(Score: 0) by Anonymous Coward on Saturday February 13 2016, @04:29PM
is it like falling asleep and dying peacefully?
(Score: 0) by Anonymous Coward on Saturday February 13 2016, @05:38PM
Was detailed in a good film " rel="url2html-14152">http://www.imdb.com/title/tt0338135/
Any doctor here care to comment?
(Score: 5, Informative) by Dunbal on Saturday February 13 2016, @09:55PM
Haven't seen the movie, but I am a doctor. Opioid overdose causes respiratory failure and cardiovascular collapse/cardiogenic shock. So you will have all the symptoms of shock - anxiety, cold/clammy skin, nausea/vomiting, rapid weak pulse, loss of sphincter control. Add to this inadequate breathing - they simply forget to breathe as the brain's breathing center is shut down. And then you die. I can't imagine it feels nice but most of the panic/anxiety will be damped by the drug - since that is what it does. You just won't care, although your body will react. According to some anesthesiologists it is involuntary (reflexive) breathing that goes but if you tell the person to take a breath they will - so you still have voluntary control. Only you don't do it because your brain is elsewhere. Of course how fast this all happens depends a lot on the dose you took and your tolerance to the drug.
(Score: 0) by Anonymous Coward on Sunday February 14 2016, @01:17AM
Hmm... I've experienced a heart attack, which was rather painful but bearable. Definitely better than two cancer deaths I was unfortunate to observe. Anaesthesia right before the bypass surgery felt just wonderful. Morphine after was very very good. See, I don't do drugs but I now understand people who do and I plan to end my days myself at some point. No way I am going to go through the cancer death. Anyway, I thought that high heroin dosage, especially steady intravenous flow, will knock me unconscious for good.
(Score: 3, Interesting) by Dunbal on Sunday February 14 2016, @02:20AM
Usually for general anesthetic you get midazolam just before being knocked under with fentanyl. Midazolam can make you trippy, relaxed, but since it also produces anterograde amnesia, usually you don't remember the effect. The fentanyl is what puts you into a deep enough sleep to be operated on. I've been in your shoes myself - have had bypass surgery, have had about 6 heart attacks, ventricular fibrillation once, etc. I had my 1st heart attack in my 20's (thanks for those genes, dad!). Anyway I can't take morphine, it makes me really itchy all over and makes me throw up. Fentanyl on the other hand.... almost worth the heart attack lol. It's a warm and fuzzy I just don't give a shit feeling. Dying while in that state can't be bad. I've never witnessed a patient die of opioids (although I've seen plenty die for many other reasons). But the theory is you die of shock and respiratory failure, which isn't fun - but if your mind is no longer in the same room while it happens - well there are many worse ways to die. I guess the trick is not to vomit and broncho aspire while you do it...
(Score: 3, Interesting) by Reziac on Sunday February 14 2016, @02:43AM
Have you ever done a full thyroid panel? (NOT just the TSH test, worth very little by itself.) VFib is typical for longstanding hypothyroid. And per a recent study, 50% of people who'd had major cardiac events were found to have low levels of T3, plus the endgame of this is fatal "flabby heart syndrome".
(I have Hashimoto's, and have had to take up reading the Journal of Endocrinology in sheer self-defense.)
And there is no Alkibiades to come back and save us from ourselves.
(Score: 2) by Dunbal on Sunday February 14 2016, @02:07PM
My illness is well documented and understood and has nothing to do with my thyroid. Ventricular fibrillation is also common as a reperfusion arrhythmia [ahajournals.org]. I was fortunate enough to be in the emergency room when it happened.
(Score: 2) by Reziac on Sunday February 14 2016, @02:51PM
Very interesting article, thanks. I'd still do the thyroid panel, given how it can affect the underlying chemistry (hypo causes calcium robbing which in turn messes up potassium levels) which I note is a critical point per the article.
And here's wishing you a 100% survival rate in the future!
And there is no Alkibiades to come back and save us from ourselves.
(Score: 2) by Dunbal on Sunday February 14 2016, @04:01PM
When I say it has nothing to do with my thyroid, I've been fully checked for that and more, several times. They even checked me for homocysteinemia. Everything.
(Score: 2) by Reziac on Sunday February 14 2016, @04:13PM
Good to know. 99% of the time they don't go beyond checking TSH, a fairly lousy metric for thyroid health.
And there is no Alkibiades to come back and save us from ourselves.
(Score: 3, Interesting) by MichaelDavidCrawford on Saturday February 13 2016, @04:52PM
and across the Columbia in Vancouver, Washington. Around here the Fred Meyer chain is a subsidiary of Kroger.
A while back I watched up-close and personal while three young men shot up. Two of them left, then the third was screaming in agony all night long. He'd told me of how hard his childhood was, I'm not surprised he sought comfort in drugs, but he sure wasn't finding that comfort.
The Taliban sells opium to finance its activities, I once read they make $400M/year. This has driven down the cost of heroin. The Portland Police Bureau focusses on getting addicts into rehab, their main focus is really the dealers.
Yes I Have No Bananas. [gofundme.com]
(Score: 3, Informative) by Anonymous Coward on Saturday February 13 2016, @05:41PM
That's how CIA financed taliban's fight with soviets; than it came home as it always does.
(Score: 1, Interesting) by Anonymous Coward on Saturday February 13 2016, @05:44PM
It also just opened a new silk road through Ukraine.
(Score: 2) by PinkyGigglebrain on Saturday February 13 2016, @07:31PM
Ironic isn't it that under Muslim beliefs and Islamic law, which the Taliban claims to support and enforce, heroin is forbidden.
The hypocrisy of the worlds major religions is the main reason I don't follow any of them.
"Beware those who would deny you Knowledge, For in their hearts they dream themselves your Master."
(Score: 0) by Anonymous Coward on Sunday February 14 2016, @01:44AM
To use it locally - yes it is, What's wrong with using it as a weapon? It was pioneered by British during opium wars with China. Propaganda was exactly like current one as well - anglos claimed they fight for free markets. Well, now Taliban fight for free markets till the last surviving anglo. Nothing much to do with faith though.
(Score: 0) by Anonymous Coward on Monday February 15 2016, @10:51PM
The hypocrisy of the worlds major religions is the main reason I don't follow any of them.
Surely a better reason is that they are all fucking bullshit.
(Score: 5, Insightful) by bzipitidoo on Saturday February 13 2016, @06:58PM
The War on Drugs, and Prohibition will stand as an example of what happens when irrational fears trump scientific findings in the shaping of policy. These are also examples of the mess made by treating an issue, especially a fake issue, as a moral failing, an act of choice, when it is much less of a choice than thought. For example, who really wants to be obese? Yet we "fat shame" the overweight all the time, as if it is entirely their fault.
The ban on marijuana was based on hysteria that the drug caused insanity. It was a literal ax murder that was used as exhibit A on why marijuana had to be banned. Reading up on the history of it, turns out this Henry Anslinger, one of the leaders of the government effort against drugs, was primarily responsible for persuading the nation to enact the ban. It's not coincidence that the ban was enacted at a time when Anslinger's agency had recently lost the major reason for their existence, as Prohibition had just been repealed. I found it telling how similar the marijuana hysteria was to the WMD hysteria used to justify the War of Choice. It is especially ironic that Anslinger was tapped for this leadership position because the agency had developed a reputation for corruption, and Anslinger was seen as honest.
The only thing I wonder about this move to allow sales of a heroin antidote OTC is why wasn't it that way all along? Shouldn't all existing antidotes be available OTC? War on Drug hysteria and ulterior motives again, I suppose.
(Score: 0) by Anonymous Coward on Sunday February 14 2016, @01:35AM
They were not done because of "irrational fears", but to suppress a revolution - to have a mechanism to put right people in prisons. Both times it worked just fine. I wonder what will be used this time around.
(Score: 2) by tathra on Sunday February 14 2016, @01:45AM
the real reason behind prohibition was simple racism [thedea.org]. "suppressing revolution[s]" was just a benefit, and irrational fears (including racism/xenophobia, along with plenty of lies and propaganda) were played to in order to get wide support.
(Score: 2, Interesting) by Anonymous Coward on Sunday February 14 2016, @12:16AM
My girlfriend bought some heroin 2 nights ago, to help her taper off the anxiety pill. She hadn't used opiates regularly since last September, when she quit Methadone cold turkey. Last night I watched her do a shot. She was irritated that I was not supportive of her restarting heron - she wasn't going to get addicted, she just needed it temporarily to get off the anxiety pill. After the second shot she fell to the floor, said it was intentional, then became non-responsive. I read somewhere recently that most opiate deaths are for ppl who restart, without realizing that their tolerance levels have decreased dramatically, so I called 911 right away.
I tried to buy naloxone at CVS in California in November, but I didn't realize that you had to special order it a day in advance. My state still requires a prescription, they've just removed all liability concerns for the prescribing doctor. Should have had it on hand...
(Score: 2, Interesting) by Grayswan on Sunday February 14 2016, @01:02AM
Naloxone is an antidote for natural endorphins as well as heroin and other opioids. As such, it can negate the natural endorphins responsible for the placebo effect. A drug that can counteract a belief.