Local supplies of the opioid-overdose reversal drug naloxone increased and became more accessible to the public in 2018.
The Indiana Recovery Alliance reports it distributed more than 26,500 doses of naloxone last year and aspires to dispense 50,000 doses this year.
Of the 30,000 doses the IRA ordered in 2018 from drug-giant Pfizer, preliminary totals indicate the syringe-services program distributed 26,646. Most, but not all, of those doses were handed out in Monroe County, according to IRA director Chris Abert.
The IRA uses two different tracking sheets to count what they distribute, Abert explained.
There’s a daily tracking log for naloxone distributed from the IRA’s office, van and at training sessions. They use another log if the Bloomington harm-reduction program travels out of county for naloxone training sessions. The hand-tabulated logs get transferred to a digital spreadsheet; distribution totals are double-checked through invoices and inventory counts.
Orders for the antidote are placed every few weeks, so the IRA’s supply features several different expiration dates.
“Our goal is 50,000 in 2019, and we have secured the funding from private donations,” Abert said. “It’s helped us build the capacity to provide naloxone.”
Donations of all denominations have contributed to the IRA’s increased naloxone supply. In recent years, $10 donations have been made on the organization’s website, work groups have raised $10,000 gifts and an anonymous benefactor donated $100,000.
“We don’t spend a dime of taxpayer money on this program,” Abert said.
Local government does fund some naloxone distribution, however, through state and federal grants.
The Monroe County Health Department distributes naloxone to organizations, such as law enforcement agencies and Centerstone, that are registered with the Indiana Department of Health as naloxone providers. Partnerships are currently in the works with the Monroe County probation department and the IU Health Bloomington Hospitalemergency room.
Though it’s difficult to keep track of ultimately how much is passed out and used through the original supply at the Monroe County Health Department, administrator Penny Caudill said doses passed out are increasing. A new shipment recently arrived at the health department to replace a shipment of 500 from August. It’s been distributed.
Naloxone training is provided at the health department, 119 W. Seventh St., where anyone can ask to learn how to administer the drug, and take some with them.
“No one is required to take naloxone after they train. Someone could participate and say, ‘I’m not comfortable to do it quite yet,’ or hopefully they say, ‘Yes, I will take some in case I come across someone who might be overdosing,'” Caudill said.
Training is mandatory if naloxone is taken from the health department, and an appointment is required.
For 2019, the IRA has a goal of offering two naloxone training sessions in all 92 counties in the state, and the alliance will focus efforts on vulnerable populations.
“It’s important that we get the naloxone into the hands of the people who do drugs and their families,” he said.
Other organizations have partnered with IRA recently provide naloxone training.
In its first of four opioid-related events, the Greater Bloomington Chamber of Commerceinvited IRA to give training and pass out naloxone. Jim Inman, Chamber director of marketing communications, said about 25 kits were passed out at that event.
The opioid-overdose reversal drug comes in a variety of forms and prices.
Most expensive by far are the Evzio auto injectors, two dose kits complete with recorded audio instructions, by drug-maker Kaleo. FDA-approved in 2014, Kaleo has increased its price from $575 to more than $4,000 a kit.
Last March, Adapt Pharma offered its Narcan nasal spray at a cost of $37.50 a dose for police and fire departments, harm-reduction groups, schools and community centers. The drug maker’s website claimed the public interest price was at a 40 percent discount.
Naloxone the IRA purchases is among the least expensive because it is administered by way of intramuscular injection — tiny medicine vial, needle and syringe.
Abert said he was contractually obligated not to discuss the discounted pricing rates the IRA has worked out with Pfizer, which purchased naloxone manufacturer Hospira in 2015.
“When I do a price comparison about how much naloxone we can get out there, compared to the state and other organizations, it’s astounding,” he said.
The IRA started its syringe services program on Valentine’s Day 2016 after the Monroe County Health Department deemed increased rates of hepatitis C infections and heroin overdoses a public health emergency in August 2015. Long before that, volunteers with the harm-reduction program offered naloxone, sterile medical supplies and personal hygiene products.
The IRA’s naloxone inventory on Thursday consisted of about 3,000 intramuscular injection doses, 150 auto injector kits and a small supply of the nose spray.
