Police: Cost of overdose antidote limits its use

But in three months since they’ve started packing naloxone, Columbus police have revived four addicts who’ve overdosed on opioids in their affluent community 40 miles south of Indianapolis.

“These were people on death’s doorstep,” said Sgt. Matt Harris. “It doesn’t take much convincing after you see that.”

As Indiana sees rising numbers of deaths from overdoses, it is joining a growing number of states that are broadening access to the overdose-reversing drug better known by its brand name, Narcan.

Injected or inhaled, the drug keeps opioids such as heroin or prescription painkillers from slowing a person’s breathing to the point that it stops. Supporters of more widespread access say the drug buys critical time to get overdose patients to a hospital.

Last week, the Legislature passed a law allowing medical professionals to distribute the drug to family and friends of addicts to use in cases of overdoses without fear of prosecution. That came a year after lawmakers cleared the way for police and other emergency crews to carry and use the drug, which was long limited to hospitals.

Yet, Columbus remains one of only a dozen police departments — out of more than 300 law enforcement in the state — to equip officers with the drug. Some police balk at carrying something that may enable illegal drug use, Harris said. They worry that it could give addicts a false sense of security.

Cost is a major factor, as well.

The price of a form of naloxone sprayed into the nose has doubled since Columbus bought its first dose. A local hospital provides the drug to police at its cost of about $36 a dose. That’s up from $18 in January. It retails for about $50.

A new-wave version of naloxone — contained in an auto-injection device similar to the EpiPen injectors used for allergic reactions — sells for $300 to $600 per dose. Pharmacies are likely to stock that version under the new law since it requires no training to use, according to lawmakers.

The price of naloxone has raised concerns elsewhere. In Massachusetts this week, the attorney general announced an investigation into the drug’s pricing, brought on by skyrocketing costs since the state cleared the way for emergency responders to carry it a year ago.

Representatives of Amphastar Pharmaceuticals, a main producer of naloxone used in Indiana, didn’t return phone calls seeking comment. But company officials have been quoted as saying they do not publicly discuss prices or supply.

In Columbus, police paid for naloxone doses with a private grant.

That’s what Vigo County Sheriff Greg Ewing did, too, working with nurse practitioner Donna Purviance, a member of the attorney general’s Prescription Drug Abuse Task Force.

“Cost is absolutely an obstacle,” Purviance said. “It’s no longer about convincing law enforcement of its value. It’s about getting into their hands.”

Ewing, who’s equipped his road officers with kits containing Narcan, said he’s committed to finding more money to keep his department’s supply fresh. The drug has a shelf life of 12 to 18 months.

“It’s hard to put a price tag on a life saved,” he said.

State Sen. Jim Merritt, R-Indianapolis, who carried both last year’s and this year’s naloxone legislation, said the state can’t afford to let price become an issue.

He hopes to secure federal funds to offset costs — for emergency responders as well as families of addicts. He’s working with the founder of the nonprofit Overdose-Lifeline, Justin Phillips, whose 20-year-old son, Aaron, died of a heroin overdose in 2013.

Merritt says naloxone saved more than 1,000 lives in Indiana last year. He’s convinced Aaron’s life could have been saved, too, had the drug been more readily available.

The measure that allows families and friends of addicts to access the drug — which took effect as soon as Gov. Mike Pence signed it last week — is called “Aaron’s Law.”

“We’ve got a crisis throughout this state,” Merritt said. “We’ve got heroin and prescription drug abuse in every city, big and small, and in every rural community in this state.”

In March, U.S. Health and Human Services Secretary Sylvia Burwell announced an initiative aimed at reducing deaths from heroin and prescription painkillers. Heroin-related overdose deaths nationally increased 39 percent from 2012 to 2013. Prescription opioids accounted for more than one-third of all overdose deaths in 2013.

Part of the federal initiative includes $12 million in substance abuse grants for states, which could be used to purchase naloxone and equip and train first responders.

Merritt welcomes the help but says the state can’t wait to see if federal dollars come through.

Opioid abuse, he said, is worsening.

Hamilton County Sheriff’s Maj. Aaron Dietz, who leads a drug task force in Hamilton and Boone counties, also fears the problem is deepening.

The price of heroin has dropped to about $6 a hit, he said. In affluent Hamilton County — the wealthiest county in the state — police seized triple the amount of heroin last year than the year before. Dietz said it amounted to about 3,000 doses of heroin.

“It’s everywhere,” he said.

One community without easy access to naloxone is Scott County, the center of an HIV epidemic linked to intravenous use of the prescription opioid Opana. The county recorded at least five overdose deaths last year, down from 19 in 2011.

Police in Scott County don’t yet have the money to pay for naloxone.

Private donations have paid for kits now in the hands of deputies in rural Parke and Vermillion counties, where quick medical care is not always readily available.

“In some of these rural communities, it can take 15 or 20 minutes for an ambulance to arrive,” said Erik Southard, former director of the Richard G. Lugar Center for Rural Health at Union Hospital in Terre Haute. “With an overdose victim, those minutes are critical.”

Southard said he’s glad to help raise private money for police who want to carry the drug, but it isn’t enough.

“Relying on private donations just isn’t sustainable — not with the amount of drug abuse we have in this state," he said.