CINCINNATI - Hundreds of Ohio pharmacies are now selling Naloxone – a life-saving drug that can reverse an opioid overdose – but local health officials say few people are tapping into the supply.
New laws hit the books last July that allow individuals to purchase Naloxone (sold under brand names Narcan and Evzio) from a pharmacy without a prescription. Since then, dozens of local pharmacies have been working to put training and other procedures in place that are required under the law before they can sell the drug.
In Hamilton County, more than 100 pharmacies say they now keep the drug on hand – up from just eight in January. Statewide, more than 1,000 pharmacies are carrying the drug as major chains including Walgreens, CVS and Kroger have begun opting in. Just last week, Rite Aid also announced it would begin selling the drug without a prescription in Ohio and Kentucky.
While the expanded availability is a big win for those battling the heroin epidemic, more work is needed, said Hamilton County Health Commissioner Tim Ingram.
“We don’t think it’s being used by the general public as often as it should be,” he said. “I would hope that anyone who knows anyone who is suffering from this disease that they will take the time to have some Naloxone close to them."
Knowledge, cost still barriers
At Hart Pharmacy in West Price Hill – a neighborhood that’s experienced more opioid overdoses than any other in Cincinnati this year - pharmacist Eric Gillespie said Naloxone is readily available to buy.
“Very few people just come in and want to outright buy it though,” he said. “Most people still have a prescription.”
Part of the problem, Ingram believes, is that most people still don’t know that they can walk into a pharmacy without a prescription and purchase the drug.
Another likely barrier is cost, said Libby Harrison who manages the Cincinnati Exchange Project.
“It can be very pricey depending on your insurance coverage, and we’ve seen the price go up over the last year,” she said.
Just a few years ago, Harrison said a 2 mg dose of Naloxone could be purchased for under $17. Now the price at most pharmacies is around $50 or more for a single dose.
In Ohio, certain Medicaid plans cover the drug, but require patients to be enrolled in substance abuse counseling.
Calls to Kroger, CVS and Walgreens pharmacies across Hamilton County revealed a range of prices for a single milligram dose of $35 to $49.50. Some pharmacies have also begun carrying two-packs of a higher concentrated 4 milligram dose that sell for anywhere from $80 to more than $150.
At Hart Pharmacy, a single 2 milligram dose is priced at $50 – which just barely covers the store’s cost of the drug, Gillespie said.
“I haven’t heard that anyone is price gouging or jacking up the costs on this,” he said.
Stronger doses needed to battle opioid scourge
As opioid overdoses spiked in August and September – fueled by a rash of heroin laced with powerful synthetic opioids fentanyl and carfentanil – first responders had to begin using multiple doses of Naloxone to revive individuals who were overdosing, Ingram said.
“These drugs can be up to 5,000 times more powerful than heroin, and it’s taking more and more Naloxone to save people’s lives,” Ingram said.
As a result, the county has begun moving its supply of Naloxone from the 2 milligram doses to 4 milligrams. In the last week more than 500 doses of the higher concentrated drug was handed out to first responders across the county, he said.
“We’re asking for stories to come back from the streets about how well this is working,” he said. “Until we can increase the infrastructure for treatment, we need to give these people every opportunity to get into treatment and we can't do that if we can’t save them.”