Paramedics, firefighters and other emergency responders have long carried the opioid overdose reversal drug naloxone. But Missouri health officials also want to put it in the hands of as many laypeople as possible.
Thanks to a $5 million grant from the federal government, the Missouri Department of Mental Health is giving naloxone away through a project called MO-HOPE.
Naloxone is sometimes called “the rescue drug” because it can revive people who have passed out from an overdose. Without it, people who have overdosed could die within minutes. It’s traditionally been administered through an injection into the muscle, but newer forms are sprayed into a person’s nose.
Over the counter, most forms of naloxone cost between $20 and $120; MO-HOPE distributes the drug for free. The group also gives presentations to law enforcement, health providers and the public at large, teaching people across the state about addiction, overdose and naloxone use.
Dozens of organizations and law enforcement agencies in the St. Louis area have received naloxone through the grant.
Nicole Browning, clinical director for the National Council on Alcoholism and Drug Abuse, an organization that helps health officials distribute naloxone, teaches classes on how to use it through MO-HOPE.
On Monday evening, about two dozen people showed up at Wentzville City Hall to watch her presentation and get two doses of the grant-funded nasal spray.
“You put the back of your fingers to their nose – that puts it into their nostril – and then you push the plunger,” Browning said as she passed around a spring-loaded practice dose of Narcan, a type of naloxone that comes in a Flonase-style sprayer. “It’s a firm, brisk push, because there’s a seal that you’re breaking.”
During the presentation, Browning compared naloxone to condoms or a fire extinguisher: something that should always be on hand, just in case.
Everyone’s a first responder now, Browning said.
“It has always historically been EMS, fire, police, and now it’s anyone who comes upon the scene,” she said. “Getting it to the hands of lay people is so important because minutes matter when overdoses happen.”
MO-HOPE’s presentations also serve as an entry point to discuss Missouri’s Good Samaritan laws and myths about naloxone use. For example, a person can’t get in trouble for buying or using naloxone, and both the victim and people who call for help are protected from drug and alcohol offenses under Missouri statute.
Browning said questions about liability are the most common when she gives presentations.
“They want to know, ‘if I give naloxone will if I get in trouble? What If I’m wrong? What if my kids get hold of it? Knowing exactly how it works and that it’s so safe to use [is paramount],” Browning said.
She said most people also don’t know Missouri law allows anyone anyone to obtain naloxone from a pharmacy without a prescription. Many insurance plans partially or fully cover the drug.
Still, MO-HOPE’s Narcan giveaway is attractive for people who may not have insurance or the means to cover a co-pay or are uncomfortable asking for it at the pharmacy.
Wentzville resident Don Wilson left with a two free doses of the drug. He said his wife has accidentally overdosed twice on her doctor-prescribed painkillers, and he’s watched EMTs revive her with naloxone. But he’s seen overdoses in strangers, too.
“I’ve watched people,” Wilson said. “One time I was driving and I saw a man sitting at a stop sign and he didn’t move. And I honked and I got out of the car and he was having an overdose.”
Naloxone, like other harm-reduction initiatives, often elicits criticism from people who think it would make people more likely to use drugs.
“I struggled with that,” said Wilson, who said he’s been in recovery from alcoholism for 30 years. “When you’re ready to address the issue, you will. Will naloxone keep people using? I sure hope not … it saves lives, and that’s all we’re in the business of right now, is to keep a person alive, and hopefully that’s their last high.”
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