Amid a surge of heroin deaths, Indiana may soon move to make an overdose-reversing drug more widely available without prescriptions to addicts, their families and friends.
The move, coming from Republican lawmakers worried that a heroin scourge is outpacing state resources, could prove controversial. Critics say increased access to the drug naloxone — known by its brand name Narcan — may encourage drug habits by giving users a way out of an overdose.
State Sen. Jim Merritt, R-Indianapolis, discounts those fears.
Naloxone has proven effective in saving lives in 14 states where it is now dispensed without a prescription, he said. And it needs to be in the hands of anyone who’s likely to be at the scene of an overdose.
Spurring the effort to make the drug more available, even among conservative lawmakers, is a significant rise in heroin deaths — from three in 2003 to 152 in 2013. That rise comes with a situation of few addiction treatment facilities.
“This is absolutely necessary,” said Merritt of non-prescription naloxone. He noted a tripling of heroin deaths in Indiana in the past three years and said, “We need to go to great lengths to make this life-saving drug available.”
Merritt said he plans to sponsor a bill in the General Assembly next year to do that. Though he has yet to craft details, he said he may propose treating naloxone much like cold remedies that contain pseudoephedrine: They’re available without a prescription but kept behind a pharmacy counter, allowing a pharmacist to offer further information when purchases are made.
Measures already signed into law by Gov. Mike Pence make it easier for police to obtain naloxone — and for family members of addicts with prescriptions.
But those measures have fallen short. Few police departments have purchased the drug, they report, because they can’t afford it. And few pharmacies stock the drug because few doctors will write standing prescriptions to families of addicts.
Naloxone is praised as a temporary measure to pull someone back from the brink of fatal overdose. Long used in emergency rooms, it is easily administered by a nasal spray or injection.
The drug is known to reverse an overdose’s effects by blocking opioid receptors that are targeted by heroin and prescription painkillers.
“This is worthy of debate,” said Sen. Patricia Miller, R-Indianapolis, chairwoman of the Senate Public Health Committee, who’s been guarded in her approach to drug policy.
Miller said she worries about the sprawling heroin problem, especially in rural Indiana.
Earlier this month, state officials created on online registry for pharmacies, local health departments, treatment facilities, prisons and other entities to register as providers of naloxone.
Only four sites appear on the list; three are in the Indianapolis area.
“It’s a terrible dilemma,” Miller said. “We don’t want to enable people who are drug addicts to ratchet up their addiction because they know they’re carrying something that will pull them out of an overdose. But we don’t want people to die because of their addiction.”
Two pharmacists in the Legislature, Sen. Ron Grooms, R-Jeffersonville, and Rep. Steve Davisson, R-Salem, are also working on the issue.
Grooms said few pharmacies stock naloxone even after the Legislature protected them from criminal prosecution or civil liability.
Reasons are many, he said. There’s been little demand to fill prescriptions, because few doctors prescribe the drug. But pharmacists also worry that they’ll encourage drug use by handing out what addicts may see an antidote, he said.
Davisson said he’s working with the Indiana Pharmacists Alliance to address some of those concerns.
“I get calls and emails from parents of kids who’ve overdosed,” he said. “They’re desperate to get their hands on it.”
In September, the pharmacy chain CVS announced that it will stock naloxone in pharmacies in 14 states that allow its non-prescription purchase.
Tom Davis, CVS vice president of pharmacy professional practices, said the move came in response to an increasing number of overdoses – now about 44,000 per year nationwide involving heroin and prescription painkillers.
CVS spokesman Mike DeAngelis said about 20 states are looking to increase non-prescription access to naloxone.