This bill to increase Narcan distribution would save lives and money
Naloxone, commonly known by the brand name Narcan, is an opioid-receptor blocker that can reverse opioid overdoses. This easy-to-use nasal spray has the ability to pull somebody back from respiratory failure, and often an almost certain death.
Anyone can administer Naloxone. Given how quickly an opioid overdose could lead to brain injury and death, a patient doesn't always have time to wait for emergency services to arrive. It would be ideal if anyone could carry naloxone on their person, just like we carry epi-pens in case of emergencies.
While patients can be prescribed naloxone from their primary-care provider to pick up at a pharmacy, and the number of those prescriptions have increased in recent years, many who need naloxone are still without it. Cost has been the most widely cited among the barriers identified. There are also many people in the U.S. without access to regular, preventative health care who never get these prescriptions in the first place.
Those with a substance use disorder are less likely to utilize regular, preventative health care. It is unclear whether, overall, this means that those with substance use disorder use other types of medical care, like the emergency room, more than the average patient. One study did find, though, that those with substance use disorder are more likely to return to the emergency room within 72 hours of a visit — a helpful metric that can be used to intervene with individuals who may not have been identified on their first visit.
A possible solution is to allow for naloxone to be distributed in the ER without a prescription and without any cost to the patient. We know that easy and free distribution of naloxone goes a long way. In fact, one study found that having a secondary form of naloxone distribution had the greatest effect on decreasing opioid-related deaths. In this study, 'secondary' means that a person at risk of an opioid overdose gets the naloxone from a community member who got it from the hospital, rather than the at-risk individual getting it directly from a hospital or pharmacy themselves. This may be due to the stigma that those with substance use disorder may have or are afraid to face in medical settings. Preventative distribution of naloxone also saves the health care system money from the overdose deaths that are avoided.
In the 118th Congress, Rep. Brittany Pettersen (D-Colo.) introduced the HANDS Act, which would allow Medicare, Medicaid and Tricare to provide Naloxone to patients at no cost. Unfortunately, the bill died in committee and has not been reintroduced in the current Congress.
One major criticism of this bill was about how it would be funded. This is an even bigger question now that the Trump administration is prioritizing budget cuts of $880 billion over the next 10 years, with much of that expected to be taken from Medicare and Medicaid's budget.
We believe that the upfront cost is worth it and would save American taxpayers money in the long run. Some studies find that preventative care saves the health care system modest amounts of money, but others find that some preventative measures, such as screenings, cost more than treating the resultant condition itself.
Yet what is often ignored is the cost that isn't directly monetary. For example, while preventing a chronic illness may cost more than treating the illness itself, the economy may lose the productivity of that person if they can no longer work due to their illness. One study found that a community health worker intervention that worked to address unmet social needs for disadvantaged people saved the average Medicaid payer $2.47 for every $1 spent.
Given this, Congress should support the reintroduction and passage of the HANDS Act. The bill should also be updated. First, it should encourage naloxone distribution not only to those with substance use disorder, but also to community members who know people with substance use disorder, since the large positive effects of secondary naloxone distribution are evident. Additionally, the bill should emphasize the importance of offering naloxone to those who return to the emergency room within 72 hours, since those with substance use disorder are more likely to do so.
Anyone can develop a substance use disorder. The opioid epidemic affects our nation's children, veterans and homeless populations. The 2023 movie 'A Good Place,' starring Florence Pugh and Morgan Freeman, tells the story of an everyday young woman who becomes addicted to prescription painkillers after a car accident, showing how substance use disorder can happen to anyone.
Both sides of the aisle can agree that we don't want Americans dying. Passing of the HANDS Act is a step in the right direction.
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