Dr. Marissa Levine, The Virginia State Health Commissioner, has issued a standing order for Naloxone, the drug used to treat emergency opioid overdoses[1]. Naloxone, often administered as a nasal spray (Narcan), is an opioid antagonist that quickly and effectively counteracts the effects of drugs like heroin, fentanyl, oxycodone, Vicodin, and carfentanil[2,3]. This new order allows patients or family members to purchase Naloxone without a prescription, where previously one was required.

In a statement delivered on November 21, 2016, Dr. Levine, noted that each day, over 24 Virginians are treated and 3 die from drug overdoses[4]. This opioid crisis is especially severe in southwestern Virginia, where there is a “growing prevalence of hepatitis C and HIV resulting from injection drug use”[5]. As a result, Dr. Levine declared a Virginia Public Health Emergency for the opioid epidemic.

This standing order comes amidst a new, potent opioid–carfentanil–that has been increasingly seen throughout the United States[6,7]. The DEA estimates this drug to be 500,000 times more powerful than heroin[8]. Rather worryingly however, carfentanil may be too potent for Naloxone to have an effect.

Several pharmacies throughout Virginia, including CVS, Walgreens, and Kroger, have begun to offer naloxone without a prescription[9]. According to a local pharmacist in Charlottesville, VA, it’s possible to walk into a pharmacy today with about $80 and walk out with a dose of Narcan without a prescription.

References:

[1] “State Health Commissioner Comments on Opioid Addiction Declaration – Virginia Department of Health,” accessed April 14, 2017, http://www.vdh.virginia.gov/blog/2017/04/03/state-health-commissioner-comments-on-opioid-addiction-declaration/.

[2] National Institute on Drug Abuse, “Naloxone,” September 26, 2016, https://www.drugabuse.gov/related-topics/naloxone.

[3] National Institute on Drug Abuse, “Opioids,” May 27, 2016, https://www.drugabuse.gov/drugs-abuse/opioids.

[4] “State Health Commissioner Comments on Opioid Addiction Declaration – Virginia Department of Health.”

[5] Ibid.

[6] “DEA Issues Carfentanil Warning to Police and Public,” accessed April 14, 2017, https://www.dea.gov/divisions/hq/2016/hq092216.shtml.

[7]“CARFENTANIL: A NEW CHALLENGE IN THE OPIOID EPIDEMIC,” GROUNDS, accessed April 14, 2017, http://www.vabioethics.com/content/2016/10/20/carfentanil-a-new-challenge-in-the-opioid-epidemic.

[8] Ibid.

[9] Associated Press, “Virginia Krogers to Offer Naloxone without Prescription,” WAVY-TV, January 31, 2017, http://wavy.com/2017/01/31/virginia-krogers-to-offer-naloxone-without-prescription/.

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