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Bill increases access to medication for overdose reversal

RALEIGH, N.C. (AP) — A medication already known to have reversed well over 2,000 overdoses of heroin, OxyContin or other opium-based drugs in North Carolina since 2013 could become more accessible in legislation recommended Tuesday by a state Senate committee.

The bill would create a statewide standing order to prescribe naloxone to anyone, something that is now allowed in two other states, according to State Health Director Dr. Randall Williams, who would write the order. Any pharmacist could fill the prescription, which in its injected or nasal-spray form can reverse a potentially fatal opioid overdose in an emergency.

“For the state to do this is bold, and this will save lives,” Williams said. “To me, it’s analogous to a lifeguard at the beach. If somebody’s out there drowning we don’t ask how they got in that situation. We just go out there and save them and then we try to help them from there.”

With drug overdose deaths soaring compared to the late 1990s, dramatic steps are required to save lives as a first step to treating addictions, Williams told the Senate Health Care Committee, which strongly supported the bill.

“There is a state interest in saving lives,” said Sen. Chad Barefoot, R-Wake, a committee member.

A 2013 law in part has allowed law enforcement and first responders to use naloxone when they come across an overdose victim and avoid potential liability. Family members of potential drug abusers now also can ask a doctor for a prescription. That law has been successful to the point that the 1,064 confirmed overdose reversals in 2015 were higher than the number of overdose deaths, according to a presentation for legislators last month.

Williams said some physicians may be reluctant to write a prescription for a third party. The bill would allow someone to go to any pharmacy and ask for the medication.

“What we’re presenting today is a bold initiative” to address “the public health crisis of our time,” Williams said, adding that some estimate that 500 people who died last year from overdoses could have been saved had the law been in place.

The legislation, which would also protect the health director from civil or criminal liability, now goes to a Senate judicial panel.

Williams said people without opioids in their system aren’t affected negatively by naloxone. Some heart-related symptoms could surface if an opioid-dependent patient begins to experience withdrawal.

Naloxone, also known as Narcan, is covered by Medicaid and many private insurance plans, according to Williams. The cost to the state is about $110 per dosage kit, but the state is likely to see no additional expenses if the bill became law because patients are less likely to use a more expensive antidote, Williams said.

Maryland and Pennsylvania have similar statewide standing orders. The Maine legislature last week overrode Gov. Paul LePage’s veto of a bill that would increase public access to naloxone. LePage argued the drug merely extends addicts’ lives but doesn’t save them.

North Carolina senators on the health care committee also are working on legislation to address substance abuse treatment. There was a more than five-fold increase in heroin deaths from 2010 to 2014, reaching 246 deaths, according to state health statistics.

“Hopefully we can do a lot to prevent individuals from getting to this point,” said Sen. Ralph Hise, R-Mitchell, the committee’s co-chairman.

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