Across the country, and in Montana, more and more people are having the kind of terrifying experience that Michael McNamara did.
“I was shooting up in a bathroom in Seattle. At a theater. Everything turned black. There was no white light. There was no friends or family waiting for you. I basically died. I overdosed on heroin.”
More people, young and old, are taking too many prescription painkillers, and some are turning to street drugs like heroin.
Luckily, for Michael and thousands of other Americans, there’s naloxone - the so-called “second-chance drug” that can reverse opioid overdoses.
“The next thing I remember, is just coming back to life. Being able to see. And I found myself on the floor of the bathroom with EMTs around me. Because they had access to naloxone, I lived. I would not be here today if it hadn’t of been for that,” McNamara said.
In most parts of the U.S., naloxone is now much more widely available than it was even just a few years ago.
But that’s not the case in Montana, which is one of only three states that hasn’t yet passed comprehensive laws granting easy access to naloxone. Here, emergency responders and hospitals carry it, and some doctors will prescribe it, but for everybody else, it’s still hard to come by.
Last fall, though, Montana turned a corner when it reached an agreement with CVS drug stores that would allow them to start selling naloxone without an individual prescription.
Christa Weathers is the director of Open Aid Alliance in Missoula, which helps people struggling with drug abuse.
"It’s a relatively inexpensive drug. It’s non habit-forming. There are very few if any identifiable negative side effects.”
Naloxone blocks opioids from reaching the brain’s receptors, meaning the overdose is stopped in its tracks, and victims start breathing again. But the effects on the body can be harsh, and people generally go right into withdrawal, so it’s crucial to call 911 for follow-up medical care.
One in five Montanans have reported taking an opioid pain medication in the last 12 months. And at least at least 120 people have died each year from prescription drug overdoses here in recent years.
So to public health advocates, it makes sense that this rescue drug should be in the hands of every opioid user and their friends and family in case of emergency.
Weathers was encouraged when CVS and Montana’s Board of Pharmacy agreed that the drugstores could sell naloxone without a prescription last September.
She started spreading the word to the more than 1,000 clients Open Aid serves in Missoula and beyond. But, it’s been harder for them to get than she hoped.
“It’s been really challenging. We encourage them to go get naloxone, and then if they can’t actually get it, or there’s some other barrier, the likelihood that they’ll really go back and pursue it? Mmm, not likely."
Open Aid’s clients report that not all CVS’ in the state have had it in stock, or have staff that are aware of the new naloxone regime and are trained to distribute the medication. Some employees were worried that someone in the midst of a heroin overdose might just walk into the pharmacy.
“There is still that stigma associated with naloxone, which is that only addicts overdose, only addicts would need naloxone,” Weathers said.
Weathers also points out that this is a vulnerable population to begin with, and there are hoops that they simply are not able to jump through.
“They have to give their information. And they have to pay. For our population at least, that represents some significant barriers. The personal info, we’re talking name, street address, personal identification points that our population isn’t exactly comfortable giving.”
CVS Health acknowledges that there have been some challenges rolling out the naloxone access program initially.
Tom Davis is a CVS Health Vice President in Rhode Island.
“People make us aware that they may have gone into a store and there was a pharmacist that may not have been aware of the program, or a pharmacy technician that may not have been, and then we’ll go back and make sure the training was conducted or we’ll go back and we’ll retrain.”
Davis says that CVS now has similar agreements with 30 other states to make naloxone more easily available. And he’s confident that they will work out the kinks with the program at the 16 locations here in Montana and elsewhere.
“We’re still in the early stages. And in many ways I think by increasing access in this manner, we’re creating a very strong foundation to move forward from, particularly as it comes to supporting treatment options,” said Davis.
Open Aid Alliance’s Weathers says, despite the hiccups in last fall’s agreement between the state and CVS, it still represents significant headway on this issue.
But, what she and other advocates think Montana really needs is what Colorado, another conservative western state, already has: legislation that will make this antidote available to everybody, in lots more places besides a CVS.
That’s called third-party distribution, "which would allow an organization like ours that serves this group of people to distribute naloxone. Train to administer and actually distribute naloxone,” Weathers said.
In Montana, at least one state lawmaker is looking into naloxone access legislation, but there is currently no draft bill. Advocates hope that 2017 will be the year.
“There’s no reason to not move forward on naloxone access unless we’re going to be in denial that the opiate epidemic is here,” said Weathers.