Minnesota has placed pharmacies at the front line of the opioid epidemic, with laws allowing them to distribute naloxone, the overdose antidote drug, without a prescription and efforts to make them collection points for unused prescription opioids to prevent their misuse.
Now state health and pharmacy leaders want to make sure that pharmacies take up the cause — and that people use these convenient locations to obtain the “rescue drug” for themselves or for friends or loved ones abusing opioids.
On Friday, they held a demonstration at Minnesota Health Department headquarters in St. Paul to promote the expanded access to naloxone and demonstrate how it can be administered in an emergency. So-called walk-up access to naloxone in pharmacies became legal in Minnesota as of Jan. 1.
“We want this medicine in the hands of people who are at risk,” said Dr. Ed Ehlinger, state health commissioner.
The event included a representative for CVS pharmacies, which has trained its pharmacists statewide on how to sell naloxone without a prescription and how to show customers how to use it. Walgreens pharmacies are providing walk-up access as well.
“We believe this increased access will give more people a chance to survive,” said Jennifer Bodmer, a CVS pharmacy supervisor.
Expanded access to naloxone, not just in pharmacies but to first-responders and clinics, is part of a broader response to the sixfold increase in opioid-related deaths in recent years. The state recorded 336 such deaths in 2015, up from 56 in 2000, according to a Star Tribune analysis of state death certificate records.
State figures aren’t yet available for 2016, but will presumably include the April 21 death of pop singer Prince from an overdose of a potent painkiller known as fentanyl.
Safe to use
The continued rise of opioid-related deaths despite the increased awareness and treatment options is a source of disappointment for Lexi Reed Holtum, director of the Steve Rummler Hope Foundation. The foundation is named after her fiancé, who died of an opioid overdose. He also was the inspiration behind Steve’s Law, which gives limited immunity from drug possession arrests to people who call 911 in an overdose emergency.
At Friday’s event, Reed Holtum demonstrated how to administer injectable and nasal forms of naloxone. (At CVS pharmacies, those drugs cost $45 and $110, respectively. Insurance coverage varies.)
“It is equally effective no matter which administering device you use,” said Reed Holtum, whose organization provides community training on naloxone as well.
Liberal dispensing of naloxone in the community is safe because the drug counters the potentially deadly effects of opioids on someone who has suffered an overdose, but otherwise has no impact, said Cody Wiberg, executive director of the Minnesota Board of Pharmacy.
Wiberg sheepishly admitted at Friday’s press event that he accidentally administered naloxone to himself once because he thought he was using a training injector when he actually was using one loaded with the medication.
“I can assure you,” he said, “nothing happened to me.”
Legislation also permits pharmacies to provide secure receptacles for consumers to dispose of unused opioid medications, which aren’t supposed to be thrown in the trash or flushed down the toilet due to environmental concerns.
CVS does not provide those receptacles, but provides sealed bags for customers to take excess opioids to police stations for disposal. That effort has already resulted in the disposal of 1,200 pounds of unused medication, Bodmer said.
Gov. Mark Dayton has urged even more action; his budget proposal for the next two years calls for a fee on prescription opioids that would raise $42 million for prevention and treatment programs.