What do Prince, the governor of Maine, and schools in western Pennsylvania have in common?
All are part of the debate surrounding a so-called “save drug” called naloxone.
As the world waits for the results of the autopsy of musician Prince, reports are coming out that opioid use may have played a role in his death last week.
Prince’s emergency stop following an Atlanta show, and reports of his nervous presence outside a Walgreen’s pharmacy hours before his death, have fueled speculation that the death of the 57-year-old pop icon may have been due to a drug overdose.
Prince’s private airplane made an emergency landing in early April in Moline, Illinois, where he was given a “save shot” for a Percocet overdose, celebrity gossip website TMZ reported. Prince’s representatives initially said he was experiencing flu symptoms.
The Star Tribune reported Tuesday that the investigation into Prince’s death is focused on the role painkillers may have had in his death.
Meanwhile, the governor of Maine has vetoed a bill that would have increased access to naloxone, saying the drug encourages people to shoot up heroin.
This comes as schools in western Pennsylvania and other regions in the eastern half of the country are stocking up on naloxone as opioid and heroin use continue to increase.
Increasing Need for ‘Save Shot’
Naloxone — known better by one of its brand names, Narcan — is available as both a nasal spray and an injection.
It can help reverse the effects of a potentially fatal opioid overdose within minutes. It’s available as a generic, with prices ranging from $0.50 to $5.30 per dose.
Still, prices on the drug are rising along with the epidemic, in some cases nearly doubling from $22 a kit to $40 a kit, according to The New York Times.
The drug first received FDA approval for opioid treatment in 1971.
Since opioid overdoses have reached epidemic levels due to an increase in painkiller abuse and heroin, more states have been responding to the crisis by making naloxone available to police, paramedics, and at-risk people, including drug users.
Jerónimo Saldaña, policy manager for legislation and organizing with the Drug Policy Alliance, said naloxone has saved tens of thousands of lives since 1996.
“It’s one tool of many tools. Naloxone can save someone’s life so they can get the treatment they need,” he told Healthline. “People with a substance abuse problem aren’t bad people. They need help.”
The U.S. Centers for Disease Control and Prevention (CDC) recommends expanding the use of naloxone, namely in rural areas where opioid deaths are higher and medical facilities are farther away.
In 2014, opioids — including heroin and prescription painkillers — resulted in 28,000 deaths, the highest year on record so far, according to the CDC. Of those deaths, at least half involved a prescription opioid.
Most States Have Naloxone Laws
In 2001, New Mexico became the first state to increase access to naloxone. Few other states followed during the next decade.
However, between 2010 and 2015 opioid and heroin overdoses increased and dozens of states joined in.
During that time, heroin and opioid use crept into white, middle-class suburbs, which is when it shifted away from a strictly criminal justice issue to a public health issue, Saldaña said.
“Getting people to understand you can’t incarcerate away a problem is a shift in the narrative,” he said.
Now, 38 states and Washington D.C. allow for naloxone to be sold without a prescription.
Selling naloxone is typically done through standing orders or collaborative agreements, such as Walgreen’s recent announcement they’d be offering naloxone over-the-counter in its 110 pharmacies in Alabama.
In Minnesota, Prince’s home state, physicians can prescribe naloxone to a third party, such as a family member, under Steve’s Law, a 2014 measure that also awarded certain protections to good Samaritans who call 911 in case of an overdose.
While more states look to increase access to naloxone and other provisions to reduce overdose deaths, some lawmakers believe providing the antidote only encourages more drug use.
Maine Governor’s Veto
Last week, Maine Gov. Paul LePage vetoed a bill that would have expanded access to naloxone.
“Naloxone does not truly save lives. It merely extends them until the next overdose,” LePage wrote, as reported by the Portland Press Herald. “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.”
Others, however, disagree with the governor’s assessment.
One in particular is Damien Pickel, police chief of Milo, Maine. In a Facebook post, the chief said LePage was “disingenuous” about naloxone and “doing a disservice to those of us who have administered it.”
“You should listen to your police, fire, ems, and medical professionals before you make any further uninformed statements,” the post states. “We're getting it done on a daily basis. We save lives — whether you're rich or poor, black, white, green or purple, addict or sober.”
In Maine, where overdose deaths increased 31 percent in 2015, family members can currently receive a prescription for naloxone.
The vetoed bill, which had support of police and health officials, would have provided better legal protections to pharmacists and allowed them to give out the opioid antidote without a prescription.
Maine’s legislators may vote Friday on whether to overturn LePage’s veto.
Schools Stocking Naloxone
While Maine’s state government may grapple with the decision to make the drug more available, other places, including school districts, want to be ready.
Some western Pennsylvania schools have stocked doses of naloxone for emergencies and even more campuses are considering it, according to Trib Total Media.
Western Pennsylvania is one area of the country that doesn’t receive much federal attention because it’s not a high drug trafficking area.
However, it has one of the fastest growing drug overdose rates nationwide, according to new research from the University of Pittsburgh Graduate School of Public Health.
Other areas with high increases in overdose deaths include clusters in southern Michigan, eastern Ohio, eastern Pennsylvania, New Jersey, much of southeastern New York, and coastal New England.
“Our research reveals several potential new drug overdose problem regions that warrant careful attention as they may not correspond to areas covered by federal resources to combat drug trafficking,” Jeanine Buchanich, Ph.D., deputy director of Pitt Public Health's Center for Occupational Biostatistics and Epidemiology, said in a press release.