Kansas may make it easier to deliver antidotes to people who overdose on opioids

Kansas is one of only a handful of states that has not expanded access to the naloxone, a drug that reverses heroin and opioid overdose. But that’s likely to change.

A bill supported by physician, pharmacist and public safety groups was introduced in the Kansas House Monday. The bill would empower police and other first responders to administer naloxone to people who are believed to have overdosed. It would also put naloxone, which is available in a nasal spray, in the hands of drug users’ families and friends.

Dr. Ryan Jacobsen, medical director of the Johnson County EMS, says naloxone, which is sold under the brand name Narcan, should be as available as EpiPens, the devices that deliver life-saving shots to persons suffering severe allergic reactions.

“We’d like the same kind of thing for Narcan,” he says. “Grandma could carry a Narcan auto-injector for her heroin-addict grandson. It’s the same kind of concept.”

Since 2000, more than 300,000 Americans have died from opioid overdoses, according to the Centers for Disease Control, which supports expanding naloxone access and use.

In 2014, Missouri passed a law allowing police, firefighters and emergency medical technicians to obtain and administer naloxone. Last year, access was expanded to bystanders. Doctors can prescribe a “rescue kit” to loved ones of at-risk opioid users. Under the law, people who administer the drug in good faith are immune from civil, criminal or professional liability.

The active ingredient in naloxone binds to opioid receptors and acts as an antagonist. The drug is fairly safe and is frequently administered to someone in an altered mental state, according to Dr. Jay Reich, the EMS medical director for Kansas City, Missouri. “For example, you might have someone who is extremely intoxicated with alcohol or some other drug but that would not respond to it, but the paramedic would still administer it,” Reich says. 

Reich says Kansas City Fire Department paramedics administered naloxone approximately 450 times last year. 

Jacobsen says naloxone administrations in Johnson County increased by 15 percent in 2016. There were 68 heroin overdoses in Johnson County in 2015. Prescription opioid overdoses are more common but harder to quantify because of the variety of opioids prescribed, Jacobsen says.

Jacobsen began thinking more about expanding access to the antidote after staff in the county’s forensics lab asked about keeping it handy. The lab workers were concerned about accidental exposure to carfentanil, a synthetic opioid used to tranquilize elephants. (The Drug Enforcement Administration issued a warning last fall that carfentanil was surfacing in more communities.) Last fall, a funeral directors’ association in British Columbia, Canada, where fentanyl use is epidemic, encouraged members to keep naloxone kits to reverse possible overdoses among staff who handle the bodies, as well as grieving guests who may have used.

Jacobsen and the EMS director in Sedgwick County worked with various stakeholders to come to a consensus and support naloxone legislation in Kansas. Montana and Wyoming are the only other states yet to enact legislation to increase access.

Rep. Greg Lakin, a Wichita Republican, is the sponsor of a Kansas House bill expanding access to naloxone. Lakin is a former police officer and prosecutor who became a family physician. The bill, which is on the Mid-America Regional Council’s list of priorities for the legislative session in Kansas, is not expected to face opposition.

As legal barriers have fallen in states across the country, access has remained an issue because of the cost. Kaleo, a privately held company that makes a naloxone injector device last year raised the price of a two-pack to $4,500.

Last summer, Sen. Claire McCaskill of Missouri and Sen. Susan Collins of Maine sent a letter to five companies that manufacture naloxone asking for information on pricing and other factors affecting access.