Mainers soon will finally be able to purchase the opioid-overdose reversal drug Narcan directly from pharmacists.
The final step in a lengthy – unnecessarily lengthy, according to some – process begins next week when the Maine Board of Pharmacy is scheduled to meet and codify rules related to a law that passed in June.
The original bill to make Narcan available over the counter actually passed more than a year ago but never went into effect. Instead it languished until the pharmacy board, the regulatory authority for controlled substances in Maine, reported back to lawmakers near the end of last year and said the law needed to be amended.
Lawmakers drafted and passed an amended bill. It became law in June without the signature of Gov. Paul LePage, who has been critical of Narcan in the past.
But the new law still needs final approval from the pharmacy board, according to board president Joseph Bruno.
He said the lengthy delay in making Narcan more widely available is frustrating because the opioid epidemic has been worsening. Last year, 376 people died from overdoses in Maine, the highest number ever recorded by far. The crisis has reached every community in Maine and has been compounded by a lack of access to effective and affordable treatment.
“We hope to have this wrapped up by next week when we meet, but this is something that really should have happened a long time ago,” said Bruno, who also is president of Community Pharmacies, which operates nine stores across the state.
Doctors already have been able to prescribe Narcan to patients and loved ones but Mark Publicker, an addiction specialist in Portland, said allowing over-the-counter sales is a crucial step that will save lives. Narcan, also referred to as naloxone, is administered as a shot or a nasal spray and, if given to a person in time, can reverse an overdose by attaching to opioid receptors in the brain.
Even without the new law, Narcan use has increased considerably. According to data from Maine Emergency Medical Services, emergency personnel administered Narcan 2,380 times in 2016, a massive increase over 2015, when 1,565 doses were used.
Those numbers do not include shots given by family members, doctors or acquaintances.
Publicker said he’s pleased the law finally passed but he remains frustrated at the overall lack of action by lawmakers to fight the opioid crisis.
Much of the debate in Augusta over the response to the epidemic has focused on spending, but the new law wouldn’t cost the state anything.
In fact, Maine didn’t need a law to make the drug available over the counter. Bruno said numerous other states have instituted standing orders by their top health officials that allows pharmacists – not just doctors – to prescribe Narcan themselves.
Many pharmacies have been waiting for the change. Walgreens and CVS, two major chains that operate pharmacies in Maine, have offered Narcan without a prescription in other states.
Erin Shields Britt, director of corporate communications for CVS, said that the chain has been in communication with the board of pharmacy on the regulations and is waiting for them to be finalized before allowing its pharmacists to dispense naloxone without a prescription.
Eric Blom, a spokesman for Hannaford, which staffs dozens of pharmacies inside its grocery stores across Maine, said the company would wait until the rulemaking is finalized before addressing the new law.
Harm reduction advocates say standing orders have contributed greatly to reducing the number of fatal overdoses.
Maine’s top health officer under Gov. LePage has never issued a standing order and the governor has not embraced Narcan as a tool for harm reduction.
Last year, LePage vetoed the original bill to expand Narcan availability and repeated an opinion that many found insensitive to those suffering from addiction.
“Naloxone does not truly save lives; it merely extends them until the next overdose,” he wrote in his veto letter. “Creating a situation where an addict has a heroin needle in one hand and a shot of naloxone in the other produces a sense of normalcy and security around heroin use that serves only to perpetuate the cycle of addiction.”
About a month after his veto, LePage shared a story he heard about a Deering High School student who overdosed and was revived three times before returning to class the same day. Portland officials, however, said the governor got his facts wrong. The incident happened in Deering Oaks Park and did not involve a student.
Just this month, though, speaking at a substance abuse forum hosted by a Bangor church, LePage appeared to soften his stance on Narcan, albeit slightly.
He acknowledged that the drug does indeed save lives but he said people should be forced to pay for the Narcan shot or be forced into rehab. He proposed a bill this year that would allow municipalities to charge people for Narcan after the first use. That failed.
Amid the governor’s reluctance to expand access to the drug, Maine Attorney General Janet Mills, who has frequently clashed with LePage and has announced she is running for the Democratic nomination for governor, used funds from her office to provide Narcan kits to police departments. Since that program started, the kits have been used 215 times, according to the Attorney General’s office.
Eric Russell can be contacted at 791-6344 or at:
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