I saw a lot of things during my 20 years working in a restaurant. But nothing compares to the overdose I witnessed. On that occasion, I was able to help the person suffering from an opioid-related overdose survive their experience. Even though I made a difference, I was still untrained and lacked the knowledge to know exactly what to do when it happened again.
Over 20 years later, I have a different job: I’m now a nurse scientist who researches ways we can reduce harm from drug use and addiction. Witnessing firsthand the impact of addiction and my own helplessness led me to ultimately earn a Ph.D. in nursing. Now, I have the training. I have the knowledge. And it’s my goal to ensure that others are also well-equipped to respond to opioid-related overdoses when they occur.
Credit: contributed
Credit: contributed
With the FDA’s decision to approve naloxone for over the counter (OTC) access, we took an important first step in that direction. While naloxone has been available by standing order at pharmacies for several years, you’ll soon be able to buy Narcan off the shelf without speaking to a pharmacist or health care provider — just like you would buy ibuprofen.
But to truly save lives, additional federal policies will be necessary. Otherwise, overdose mortality rates will continue to climb.
OTC naloxone is an incomplete response without two additional measures: making it affordable and enacting a federal Good Samaritan Law.
Make naloxone affordable
Currently, Narcan costs about $140 for a two-dose box. That price places it well out of reach for many people.
Federal legislators should take steps to ensure that Narcan becomes and stays affordable. In the same way that government funds subsidized COVID-19 vaccines, so, too, government funds could subsidize naloxone —at least until mortality rates from the opioid epidemic have stopped rising.
Our elected representatives should also mandate that insurers, both public and private, cover their share of the medication — and do so without penalizing or later denying coverage to the person who purchases it.
Federal Good Samaritan law
As of March 2023, all 50 states and the District of Columbia have some form of medical amnesty law relating to naloxone. These statutes provide legal protection for people who experience an overdose and need medical care and for people who seek or provide care on behalf of someone experiencing an overdose. But the laws vary from state to state and can be confusing.
A federal Good Samaritan law would provide nationwide immunity from arrest, charges or prosecution when individuals who witness or undergo a drug overdose reach out for help. Nationwide medical amnesty will change the culture of secrecy and shame that surrounds overdose situations. We need Americans to purchase, carry and administer naloxone to those in need. Stigma and fear continue to pose barriers to the public acceptance of naloxone. Making the medication available over the counter will accomplish nothing if people are afraid to buy, carry or use it.
At the end of the day, the most important — and difficult — step in the long term is our national willingness to decriminalize drug use.
People who use drugs are not criminals. But we treat them as if they are. Until we stop locking people up for drug possession and drug use, stigma and anxiety will continue to push the problem underground, discouraging individuals and communities from seeking help when it’s most needed.
No one should die from using drugs. Making naloxone available over the counter is a valuable and encouraging step towards decreasing deaths from the opioid epidemic. But in the absence of additional engagement at the federal level, the death rates will keep climbing.
Sarah Febres-Cordero, a waitress for 20 years at an Atlanta pizza restaurant, is a postdoctoral fellow at Emory University’s Nell Hodgson Woodruff School of Nursing and ambassador for the Atlanta Harm Reduction Coalition.
About the Author
