What are the Naloxone benefits?
A medication used to stop and reverse opioid overdose is soaring in price and is costing south Florida counties more money than ever before. Used by first responders that arrive to the scenes of victims who overdosed on heroin or other opiate-induced drugs; Naloxone is a vitally important medication that saves thousands of lives per year but its rising cost is worrisome. Returning back to 2012, South Florida counties collaboratively spent around $100,000 on Naloxone doses while in 2016 this figure soared to $324,000 – a $230,000 increase.
With the cost of Naloxone rising in conjunction with the growing number of overdose cases, counties are stretching budgets to supply the opiate-overdose antidote to first responders that handle such calls. “Naloxone is a medication that we cannot go without” – cited in an interview by a South Florida Emergency First Responder crew member. “Its use and effectiveness is an invaluable tool that allows us to save lives”.
One such case that shows just how impactful Naloxone can be in saving the lives of those who overdosed is the recent survival story of a gentleman named Matt Kluckowski. By day, Mr. Kluckowski worked as a chef at Applebee’s where he earned an honest living that enabled him to support his use of heroin.
It was a typical Friday, payday, and Matt was anxiously waiting for the direct deposit to reach his bank account. Once his weekly pay posted he wasted no time and headed to the ATM immediately to withdraw his hard-earned money. With cash in hand, Matt was prepared to meet with his dealer where he would purchase the Heroin. As he lies on the couch with a needle in his left hand, he positions himself for injection of the tainted-looking heroin (described to have a “greyish tint”).
This took place on September 7th, 2015.
As Matt was enjoying the sudden euphoria and loss of depression he realized that he was experiencing a “high” that he never felt before – one in which was undesirable. Unfortunately, due to the effect(s) that the heroin had on Matt, he lost his balance and fell down a flight of stairs; an accident which resulted in his death.
Thankfully, a bystander who witnessed the fatal fall called 911 and notified local responders of the incident. Upon the paramedic’s arrival, Matt was unresponsive; showing no sign of life.
Paramedics administered 4 shots of Naloxone to Kluckowski and then used a heart defibrillator on him. Despite numerous revival attempts by paramedics, there was no pulse, no brain activity, and no heart rate.
Then, a miracle occurred…
As Matt was being driven in the back of an ambulance to “where they bring dead people”, in Matt’s his words, the doses of Naloxone finally kicked in and brought him back to life as he suddenly gasped for a breath of air.
Following this tragic incident, Matt decided to fly from his home state in Maine to South Florida where he would receive treatment for his heroin addiction. He’s now sober, lives a drug-free lifestyle, and currently works as an addiction counselor at a South Florida recovery center.
Matt being able to work and help others is due to the fact that Naloxone gave him a second chance. A chance that will allow him to live and help others with addiction while living a purpose-filled life.
Naloxone is heavily relied upon in South Florida by emergency first responders. It saves lives daily and it’s and works by ridding the brain receptors of opioid molecules which quite literally revives overdose victims so they can begin to breathe once again. A fast-acting overdose solution to say the least, Naloxone is highly effective at overturning the effects that a heroin overdose causes which makes it a much needed antidote. Regardless of the cost, regardless of how stretched county budgets are, it’s an antidote that all medical responders need to be equipped with in order to save the many lives they do.
By no means is Naloxone a “new” drug. In fact, it was first formulated and used back in the 1960’s era which is around the same time ibuprofen was discovered. Since Naloxone’s discovery 60 years ago that average “cost per dose” was under $5. Being that Naloxone, even to this day, is the only drug that can reverse the effects of an opioid overdose quickly enough in order to revive a patient; its must-have status has continued to present day despite the sudden influx in its price.
From less than $5 per dose to now being $20+; counties are burdened with having to spend a copious amount of more money to arm first responders with the life-saving medication. “Naloxone is truly a miracle drug“, a statement made by Neal De Jesus, the Chief of the Delray Beach Fire Rescue.
Neil went on to state:
“We can’t do without it. It’s either purchase the drug and administer it to save lives, or don’t buy it and watch people die.”
This statement alone is an alarming signal demonstrating how Naloxone is heavily relied upon. Without Naloxone, fatalities would climb as the opioid addiction grows. Despite the rising cost of the drug, saving lives is much more valuable then the inflated costs. However, the climbing cost of Naloxone has some skeptics worrying that county budgets will one day fall short of being to supply the number of required Naloxone doses that response units require.
There’s an average of 115 Americans dying every day from opioid overdoses and rising costs could result in growing fatalities if counties are unable to provide as much of the medicine that’s needed due to the price. That daily figure is reported by the Centers for Disease Control and Prevention. First responders in South Florida and across the nation need a consistent supply of Naloxone and the need for it now is higher than ever before.
The increased cost of Naloxone is mainly being covered by tax-payer dollars but the excess spending on Naloxone due to the price hikes are going to affect other county sectors that may need funding as well.
In Broward County, where opioid-induced overdoses occur frequently (537 heroin overdose deaths in 2016), each and every responder carries with them Naloxone as it quickly reverts any affects initiated by the Heroin.
Sometimes, depending on the potency of the opiate, it can take 3-5 doses of Naloxone to revive a patient, not only 1 or 2. Some cases are more severe as the intensity of the opiates varies from user to user. This makes the fight against overdose a costly one since the cost of a single dose of Naloxone is multiplied per patient (you can see how this could add up).
“We carry it in our first-in bags so when we arrive at a patient’s side, it’s readily accessible“, stated Bryan Spies, the Battalion Chief of emergency services of his county. The Naloxone is carried by first responders in a bag along with other emergency items such as glucose, oxygen, and aspirin.
When first responders arrive to the scene for a call, they don’t know what to expect. Because of the number of occurring heroin doses is growing, first responders need to have Naloxone readily available in the event that the victim suffered a Heroin overdose. An overdose requires near-immediate attention with a dose of Naloxone; every second counts and as such every response team needs to be supplied with it.
The number of overdose deaths related to prescription pain kills and heroin has become an epidemic and is now in the news routinely in the US. The public awareness about this pressing issue has certainly reached an all-time high. While there was a large funding initiative by the White House a couple years back to combat the epidemic it hasn’t seemed to slow down the need for Naloxone as overdose deaths are steadily climbing. Meanwhile, as the demand for Naloxone increases so does the price and growing costs of the drug has been persisting for the past 10 years now.
Also referred to as Narcan, Naloxone’s a non-toxic and non-addictive drug that blocks the opioid receptors in the brain. Due to this, the brains opioid receptors cannot interact with heroin or prescription painkillers and Naloxone makes this process occur in a matter of seconds. This is the reason that Naloxone has been increasing in price and why it’s so effective at saving many lives. In 2014 alone, Naloxone was responsible for saving 28,647 people from dying from heroin overdose.
Going back ten years, the average cost per dose for Naloxone was only $1. With a shift in government viewpoints where drug use was viewed as a medical problem rather than one that’s criminal; the US government began mandating that states require their officers and first responders to carry Naloxone on them.
This is the reason that Naloxone has increased in prices, now up to $40 per dose!
Because both first responders and law enforcement are all required to carry the life-saving medication on their person, Naloxone has soared in price but its value is priceless. Because of how needed it is, all counties have experienced increased spending with some spending over 1,000% more than what the medicine cost just a few years prior.
Starting off with the City of Miami Fire Rescue, they spent 1,340% more in 2016 on Naloxone than in 2013. In that same time span spending increased by 1,307% for the Delray Beach Fire Rescue, 1,113% for Palm Beach County Fire Rescue, 285% for Monroe County Fire Rescue, 214% for Fort Lauderdale Fire Rescue, 179% for the City of Miami Beach Fire Rescue, and a 155% for the Broward Sheriff’s Office Fire Rescue department.
To put this in to perspective, in 2013, the City of Miami Fire Rescue purchased 400 units of Naloxone throughout the course of a year. That number increased to 4,500 in 2016. The Palm Beach County Fire Rescue purchased 1,250 units of the overdose antidote that same year and in 2016 purchased 5,920 (five times the amount).
The number of overdose cases is rising at such an alarming rate that the Naloxone bill for the Palm Beach County Fire Rescue department was $205,000 (when their annual spend on Naloxone use to be $18,000). That’s an increase of 1,100%!
Other cities are being impacted as well such as Miami and Delray. Miami Fire Rescue use to spend $3,600 on Naloxone annually; now, they spend 14 times that figure. The Delray Beach Fire Rescue department used to spend only $2,100 annually on Naloxone – their cost too has increased to 14 times that amount.
By nature, the more overdoses that occur, the more Naloxone is going to increase in price (because it’s needed more). It’s the classic “supply and demand” sort of a situation. Individuals, more and more of them are turning to heroin or other opiate-induced drugs to appease cravings and withdrawals which overall is going to grow the number of overdose cases in South Florida.
While the price of Naloxone is rising quickly so are the number of overdoses and there’s no reason to believe that there’s not a correlation between the two. This rising cost is effecting police departments, fire rescue, and EMS agencies and this is sparking concern in Congress.
According to information reported by WLRN, in 2013, the Miami Fire Rescue paid $9 per dose of Naloxone which came from a California-based manufacturer known as Amphastar Pharmaceuticals. Just a few years later, in 2016, the price per dose soared to $40.
This is an enormous price influx and is expensive even if you’re purchasing only a single dose. But when you’re purchase 4,500 doses in a year (the number of doses purchased by Miami Fire Rescue in 2016), it really starts to add up. However, the Miami Fire Rescue said “a price tag isn’t given on saving a life”.
This is certainly a commendable statement and represents how committed Miami and other South Florida counties are committed to combating the heroin overdose epidemic – regardless of the cost.
Dr. Vikram Tarugu, M.D, is the CEO of Detox of South Florida, Inc and medical professional focused on addiction. A veteran in the medical field with over 25 years of professional experience. He is a consultant for many South Florida Rehab centers. Patients travel from allover the US to seek his help with addiction and Hepatitis C treatment.
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