Surgeon general: Naloxone should be widely prescribed, carried

Kevin B. O'Reilly
Editor
AMA Wire
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Nearly 80 percent of opioid-overdose deaths happen outside of a medical setting, meaning that—in addition to first responders—family members and friends are commonly the ones  to find a loved one who has overdosed. When they make that discovery, a quickly administered dose of naloxone can be lifesaving, yet too few Americans know about the opioid-overdose antidote, how to get it or how to use it.

In an effort to change that, U.S. Surgeon General Jerome M. Adams, MD, MPH, has issued a public health advisory on naloxone that explains the drug’s benefits and urges people at elevated risk of opioid overdose or close to someone at high risk to:

  • Talk with their physicians or pharmacists about obtaining naloxone.
  • Learn the signs of opioid overdose, such as pinpoint pupils, slowed breathing or loss of consciousness.
  • Get trained to administer naloxone in the case of a suspected emergency.

The surgeon general’s advisory—the first of its kind in more than a decade—also calls on physicians to prescribe naloxone to their patients at risk for opioid overdose as well as their friends and family members.

“You have an important role to play in addressing this public health crisis,” the advisory says.

Dr. Adams said in an interview with National Public Radio that naloxone should become as common as other lifesaving interventions commonly administered by non-health professionals.

“We should think of naloxone like an EpiPen or CPR,” he said.

Patrice A. Harris, MD, chair of the AMA Opioid Task Force, said the AMA strongly endorses the surgeon general’s advisory.

“The AMA Opioid Task Force has encouraged physicians to co-prescribe naloxone for all patients at risk of overdose,” she said. “Surgeon General Adams, physicians, first responders and public health advocates all recognize that naloxone is a literal lifesaver and a vital tool in our fight against the opioid epidemic.”

Dr. Harris reinforced the surgeon general’s message to the public.

“Patients, family members and friends should not hesitate to ask their physicians to prescribe naloxone so they can save their own or their loved one’s lives. Many states have made naloxone available without a prescription,” she said.

“All forms of naloxone should be readily available and covered by insurance plans with minimal or no cost-sharing,” Dr. Harris added. “The AMA looks forward to working closely with the surgeon general’s office to help bring an end to the epidemic of opioid overdose deaths.”

An AMA membership means you’re fighting to prevent unintentional drug overdoses. In collaboration with state medical societies and partners, the AMA has fought for—and helped shape—naloxone-access laws in all 50 states. By making this medication readily available, tens of thousands of deaths in the U.S. have been prevented.

If you have prescribed naloxone to a patient, the AMA wants to hear about your experience to help its inform its advocacy on behalf of patients and physicians. Share your story.

To help end the opioid epidemic, the AMA Opioid Task Force also recommends that physicians:

  • Register for and use their state prescription drug-monitoring program to make more informed prescribing decisions.
  • Ensure they have the education and training on effective, evidence-based treatment.
  • Support and advocate comprehensive care for patients in pain and those with a substance-use disorder.
  • Put an end to the stigma that interferes with comprehensive treatment for patients in pain and patients with opioid-use disorder.
  • Work with their patients to promote safe storage and disposal of opioids and all medications.

Each day in the United States, more than 115 people die of opioid overdoses, according to data cited by Dr. Adams in a Viewpoint essay published in JAMA. That data is indicative of a “national public health emergency,” he added.

The goal of the advisory on naloxone, he concluded, is straightforward: “to broaden the public awareness, availability, and use of life-saving naloxone to reduce opioid overdose mortality.”

The AMA offers online CME to expand your understanding of the opioid epidemic. Explore educational content such as "A Primer on the Opioid Morbidity and Mortality Crisis: What Every Prescriber Should Know."

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Oct 15, 2018
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