Generic Version of Opioid Overdose Antidote Naloxone

One of the most life-saving antidotes for an opioid overdose is the drug Naloxone, and it’s availability is essential in high-risk areas for saving lives. One of the major issues affecting its use is the price, as pharmaceutical companies have been known to increase the price of this drug on multiple occasions. For example, the company Kaleo, with its drug Enzio, has jacked up the price of this brand of Naloxone from $575 at its approval in 2014, to currently $4,000.

This means publicly funded programs that aid in saving patients from overdose are able to buy less of the drug, which is unacceptable. However, one way to combat this is with development of generic drugs, and the first generic Naloxone has reached FDA approval, which can be administered by anyone, without need for medical training.

This has strong live-saving implications in that it would improve access to Naloxone in poorly funded areas, and they would not need a medical profession to be present to give the antidote, making it easier to administer the dose as quickly as possible.

The spray will be approved for use by anyone to help with an overdose, regardless of their medical training.”

There’s an important word here … “medical.” While Narcan and its equivalents can be used by someone without medical training, some basic knowledge is required by the person administering the antidote — for his or her own safety. Revived overdose patients don’t peacefully open their eyes like someone waking up from a nap. Instead, they become immediately violent for a short period of time. The rescuer needs to be aware of this and move out of the way.

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Still, this is great news.  Hopefully, this lower cost will enable the overdose antidote to be more readily available.  It should certainly help the towns most hard-hit by the opioid crisis that are finding their budgets stretched thin by the costs of Narcan. 

Not all patients wake up violent. (But they often can you’re right)

Even more important is that narcan administered nasally is far less effective than intermuscular injection which can be done with a minimum amount of training. In BC they’re handing out kits with the IM needles and doses in ampules. Even more important than that is that the patient needs oxygen more than they need narcan. They’ll live without narcan, they won’t live without oxygen. If you’re around people where overdose is likely, carry a 1 way pocket mask and a pair of gloves. Rescue breathing is key to the chain of survival on any breathing emergency. (overdoses are breathing emergencies, the fact that you know the cause is fairly immaterial)

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I’m a paramedic. I’ve seen quite a lot of overdoses. I’ve personally seen two patients become violent after administering narcan. Both of those cases were from people abusing stimulants along side their narcotics. Violent dramatic wake-ups are the exception not the rule. If I were to describe the average OD wake up, I’d describe it as a groggy person being yanked out of a nap. Momentarily confused sure but typically their first reaction is to curse their own actions and cry rather than punch someone. Of course any time narcan is administered someone with medical training should be called. The main disadvantage to this I see are different types of packaging generics may come in. When narcan was first made available over the counter in my state it was packaged the same way we had it on the ambulance- a syringe that needed to be assembled and a nasal atomizer (or needle) that needed to be attached. Now the over the counter(or RX narcan available directly to patients) available narcan comes in a little nasal spray bottle not any different than your Flonase allergy spray. Just have to make sure there’s training out there for people if the cheaper options come packaged less conveniently.

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