In the same way that regular people were once encouraged to learn the Heimlich maneuver or cardiopulmonary resuscitation, US Surgeon General Jerome Adams, MD, MPH, issued an advisory April 4, 2018, urging more Americans to routinely carry naloxone.

"We should think of naloxone like an EpiPen or CPR," Adams told National Public Radio's Morning Edition.1 "Unfortunately, over half of the overdoses that are occurring are occurring in homes, so we want everyone to be armed to respond."

"The call to action is to recognize if you're at risk," said Adams, who is an anesthesiologist. "And if you or a loved one [is] at risk, keep within reach, know how to use naloxone."

Retail pharmacies in most states sell naloxone without a prescription, and Walgreens announced it will carry naloxone in all of its pharmacies. Between 2013 and 2015, researchers found a tenfold increase in naloxone sold by retail pharmacies in the United States. While naloxone is now widely available in most states, it still isn't available to everyone.

Prices have increased along with demand. Naloxone-filled syringes that used to cost $6 apiece now cost $30 and up. A two-pack of naloxone nasal spray can cost $135 or more. And a two-pack of automatic naloxone injectors runs more than $3700.

NPR's Rachel Martin asked Adams about the Trump administration's broader plan for addressing the opioid epidemic. The interview can be found online on http://NPR.org (see reference below). In short, Adams said he believed the Trump administration would find ways to make naloxone more accessible and address the root causes of the opioid epidemic in the country.

"If you come in at 3 a.m., having been resuscitated from an overdose, we need to have either an immediate access to treatment available for you, or, what's working well in many places is a peer recovery coach-someone who's been through this before and who can speak to you in a language that will resonate, and basically can be with you until you're in recovery," Adams told NPR. "Those are the kind of systemic changes we need to make sure naloxone is a touch point that leads to recovery."

Adams noted that Congress approved $6 billion in funding to respond to the opioid epidemic. States can apply for grants to purchase naloxone to give out for free.

"We're also working with insurers," he said. "Ninety-five percent of people with insurance coverage, including Medicare, Medicaid, Tricare and Veterans Affairs, are actually able to get naloxone with little or no copay, and we're working with them to make that copay as small as possible."

Adams said he is also working with Adapt Pharma and Kaleo, both of which make naloxone available in the US, to find ways "to keep costs low."

"From an economic point of view," Adams says, "unfortunately, there are so many people who need naloxone that drug companies are going to make their money one way or the other."

Before being appointed surgeon general, Adams was an associate professor of clinical anesthesiology at Indiana University School of Medicine and a staff anesthesiologist at Eskenazi Health, where he was chair of the Pharmacy and Therapeutics Committee. He is the immediate past chair of the Professional Diversity Committee for the American Society of Anesthesiologists.

Reference