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Surgeon General’s Bold Move on Naloxone

April 24, 2018

In the past, I have been skeptical of this administration’s handling of the opioid crisis. Despite some good rhetoric, in today’s political terminology the president’s plan of a national opioid emergency turned out to be a big “nothingburger.” In my call to action however, I did note one obvious path forward for the administration.

I proposed that expanding access to the lifesaving drug naloxone, commonly known by its trade name Narcan, should be at the top of the agenda of anyone leading the fight against opioids. In a move that bodes well for the future of combating this epidemic, the Surgeon General, Dr. Jerome Adams, agrees with me.

In a wide-ranging recommendation last week, Dr. Adams called for sweeping expansion in the use of naloxone. In his recommendation, he proposed a massive increase in the availability and layperson use of naloxone. As it stands right now, naloxone is usually carried and administered by traditional first responders – police, fire, EMTs, and other rescue personnel. Other than a few prominent examples, such as the Narcan-wielding librarian in Pennsylvania, most of the public does not have access to and does not know how to administer naloxone.

The Surgeon General wants to change that. Dr. Adams wants to put naloxone in the hands of friends, parents, coworkers, and yes even those struggling with addiction. Over 42,000 Americans died of an opioid overdose in 2016, and this is one way to lessen that toll. However, it is important to acknowledge what naloxone is and what it isn’t.

Naloxone is not an addiction cure. It does not remove or even reduce the cravings for opioids, and it does not reduce future use. It is, however, a lifesaver. It buys the person who has been revived one more shot at getting clean, and thus one more shot at life. Many people who have been administered naloxone would otherwise be dead, and in my mind that makes it worthwhile.

There is concern in some quarters that naloxone simply enables drug use. If users are encouraged to carry a “heroin get-out-of-jail-free-card,” some worry that will only promote use. However, that dangerous use is already happening. Many people will still use opioids at life-threatening levels whether or not they have naloxone handy. We have the tools to reduce the death toll, so now is the time to make sure they are available.

As I have said before, increasing the availability of naloxone is a good first step, but only a first step. We cannot lose sight of the larger epidemic. We must continue to find and fund ways to help people stay sober and take additional action to help people avoid misuse, abuse, and addiction in the first place. But right now, naloxone represents another chance at making that happen. Yes, we want more people in long-term treatment and addiction and recovery management programs, but sometimes that first step requires simply saving someone’s life.