Southwest Airlines will now carry the opioid overdose-reversal drug naloxone on flights.
Ballwin resident John Gaal and other advocates have been lobbying the airline to carry naloxone, which is also called Narcan, to protect passengers from opioid overdoses since Gaal witnessed an apparent overdose on a Southwest flight in October 2022.
“This stuff's happening on the ground and obviously 35,000 feet in the air,” he said. “You know, you got to prepare for this stuff.”
Public health officials, doctors and advocates for harm reduction practices have long touted the use of naloxone to keep people from dying after taking potent opioids, including the synthetic opioid fentanyl, often found in heroin and other street drugs.
On the 2022 flight, Gaal, the in-flight crew and several medical professionals on board helped revive the man after administering the naloxone that Gaal and his wife carry with them.
The man was showing telltale signs of an opioid overdose, he said.
“He had beads of sweat on his forehead. He had vomit on the side of his face. He wasn't responding to his name,” Gaal said. “And when I opened his eyes, truly, his pupils were the size of a pinhead.”
After Gaal and a doctor administered the nasal spray to the patient, the man was able to return to his seat, and the flight went on as planned, Gaal said.
Southwest will be updating its onboard medical kits throughout the year until the entire fleet has the new stock, a spokesman for the airline said.
“With Customer Safety and comfort at front of mind, Southwest is enhancing its onboard emergency medical kits above and beyond current FAA requirements,” company officials said in a statement.
Once only sold to people with a prescription, naloxone became available over the counter in 2023.
Government officials in the St. Louis region have been placing naloxone in libraries, rec centers and other public spaces to make it as accessible as possible for people to use when they witness someone experiencing an overdose.
Federal officials require planes to stock epinephrine, nitroglycerine tablets and other drugs to handle allergic reactions, heart problems and other issues. Flights also are required to have automatic external defibrillators on board.
The Federal Aviation Administration does not require airlines to carry naloxone in their medical kits, but United, Alaska Airlines and other carriers have begun to stock it on their planes.
Some airline professionals have called for including the nasal spray on all flights.
“Naloxone is not a standard on-board medication in commercial aviation, which renders individuals at a higher risk of death by overdose in the air than on the ground,” members of the Association of Flight Attendants wrote in a letter to FAA administrators in 2018.
“Given the opioid epidemic that our nation is experiencing and the availability of an effective and low cost life-saving intervention already being used by first responders throughout the U.S., we request the FAA to use its statutory authority to…revise that list,” they wrote.
Southwest officials say they’re also updating their kits with auto-injectors of epinephrine, which many refer to as “epipens,” for flight staff to use in case someone has an allergic reaction. And they’re adding more effective stethoscopes that can be heard over in-flight noise.
