Opioid overdose antidote naloxone is in short supply in community-run programs across the country, according to advocates. Overdose deaths have risen to record levels and the shortage has persisted since May 2021 despite extensive media coverage.
The shortage may be resolved soon, but systemic changes in the sale and distribution of naloxone will be necessary to ensure its widespread availability in the future.
Naloxone belongs to a class of drugs known as opioid antagonists, which bind to our cells’ opioid receptors and prevent other opioids from activating them. Overdose symptoms such as the inability to breathe can be quickly reversed by administering naloxone to those who are currently experiencing an opioid overdose.
To administer Narcan, patients can use a nasal spray sold under the name Narcan, or administer it intravenously, intramuscularly, or subcutaneously. Evzio developed an auto-injectable version, but the drug and its generic version were taken off the market in 2020 after complaints about their high price.
Nasal sprays and auto-injectables, which were both patented as novel drug delivery methods, are more expensive than injectable naloxone, which is typically given intramuscularly. The Opioid Safety and Naloxone Network Buyers Club, a nonprofit organization founded four years earlier, negotiated a deal with pharmaceutical company Pfizer to purchase naloxone for less than $5 a dose—far less expensive than even discounted Narcan, which can cost around $75 per dose. Eliza Wheeler and Maya Doe-Simkins, co-directors of the group, have recently renamed Remedy Alliance/For the People.
With Pfizer’s help, Remedy Alliance has become one of the largest naloxone suppliers in the country and has helped procure more than one million doses each year. A network of more than 100 programs has been set up, all of which rely on the organization for their generic injectable naloxone supply.
Harm reduction, an approach that aims to reduce the negative health effects of drug use without necessarily advocating for abstinence, is at the heart of many of these programs, which include health departments, syringe exchange programs, and mutual aid networks.
Pfizer’s injectable naloxone began experiencing manufacturing issues last year, as first reported by Filter. It has been suggested that the supply chain issues that have afflicted so many industries are linked to the pandemic’s effects.
When asked about the shortage by the Washington Post at the time, Pfizer denied that its production of the covid-19 vaccine was to blame for it. Due to a variety of factors, Remedy Alliance and its affiliates have been forced to use up all of the extra medication they had over the past year.
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