Naloxone

January 10, 2024

We were driving through Oklahoma last week on the way to Wichita and stopped at one of the many rest areas along the interstate highway.  This was the kind that has a fast food restaurant on one side, a convenience market on the other, and shared restrooms in the middle.  I decided to stretch my legs and went inside to browse the snacks and odd state themed collectables these stops are known for.  The typical travel brochures were prominently placed just outside the restroom entrances, and next to them was a brightly colored vending machine.  At first, I could not figure out what was dispensed in the rows of boxes on display, but it was clear the product was the same for each box.  When I took a closer look I read, “Naloxone and Fentanyl test strips” and in larger letters, “SAVE LIVES”.   

When I looked online, I found the Centers for Disease Control and Prevention (CDC) estimated that more than 107,000 Americans died of drug overdoses in 2021, or a 15% increase from the previous record set in 2020.  This amounts to roughly one overdose death every 5 minutes.  In Oklahoma, the CDC’s estimates show the state saw an even greater rise in overdose deaths, or a 22% increase compared to the previous year.  The provisional count for overdose deaths in Oklahoma for the year ending December 2021 is predicted to be 923, compared with 755 the previous year.  Unintentional fentanyl overdose deaths in Oklahoma have also skyrocketed and reached almost 700 from April 2022 to April 2023.  The life-saving naloxone nasal spray is available over the counter at local pharmacies, but a package of two doses can cost almost US$45 causing many to wonder if the product can make it into the hands of those who need it.  As fentanyl overdose deaths rise, Oklahoma began a campaign to get free Narcan (naloxone) to anyone who needs it.  “Mothers and fathers are losing their children.  Children are losing their brothers and sisters,” said Dr. George Monks, former President of the Oklahoma State Medical Association. “So, we’ve got to get control of this situation.”

Six months after placing Naloxone vending machines across Oklahoma the state has dispensed more than 26,000 doses (13,000 boxes) and boosted awareness of fentanyl overdose.  Naloxone is an anti-overdose medication also known by the brand name Narcan.  Heath Hayes, communications chief for the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS), said only half of the state’s available vending machines have been placed so far.  Motorists will have access to free naloxone and fentanyl test strips at vending machines at seven of Oklahoma’s busiest turnpike travel centers under a partnership between the ODMHSAS and the Oklahoma Turnpike Authority OTA).  In addition to offering the machines at public locations on turnpikes, OTA also added Narcan and fentanyl test strips to the first aid kit of more than 350 agency maintenance and construction vehicles due to the potential for workers to possibly be exposed to these substances when working crash sites.  The department will place 40 vending machines in zip code locations where overdose prevalence in Oklahoma is high.  This the largest scale overdose initiative in the US. 

THOUGHTS:  Overdoses can be accidental or intentional.  An accidental overdose is the result of mistiming doses of medication, overconsumption of medication without knowing the danger, or using multiple substances at once.  Intentional overdoses are attempts at ending one’s life through the overuse of a substance.  More than four times as many people died from drug overdose in the US than from homicide, and 72% of those deaths are related to fentanyl and the majority of those are unintentional.  ODMHSAS has provided 213,528 Fentanyl test kits and 427,056 Naloxone doses to Oklahomans since 2021 in addition to the 13,067 boxes and 7,025 test strips in the vending machines.  During fiscal year 2022 Oklahoma’s overdose prevention funding was US$2,481,405.  This is a societal problem, not a legislative one.  Act for all.  Change is coming and it starts with you.