The man is lying on a sidewalk, experiencing an opioid overdose. You recognize the signs, and know exactly what he needs: naloxone. But today, unlike other days, you don’t have the medicine on you. You call 911, praying paramedics can arrive in time to save the man’s life.
That was the situation on State Street in downtown Salt Lake City, Utah last month when County Mayor Jenny Wilson (D) witnessed an overdose on her way home from work. Luckily, Tiffani King, a local resident, also arrived on the scene and was equipped with naloxone.
King revived the man, and on February 11 was honored as a “hero” at a meeting of the Salt Lake County Council about naloxone. The Council was briefed by health officials about how to administer the overdose antidote, and the mayor gave a kit to each council member.
“Some of you might have people you care about that just had a major surgery: Have Narcan or have naloxone in your home because they could accidentally misuse or intentionally misuse,” said King, as reported by The Salt Lake Tribune. “I think the most important thing is these people’s lives and the breath they get to take every day, no matter what situation they’re in.”
King’s quick response to an emergency is inspiring, and the council deserves credit for using the incident as an opportunity to educate more people about naloxone. But is the state of Utah, where about 6,000 people have die of opioid-related causes in the past 20 years, making it easier for people to get naloxone? The answer is not so clear.
Since 2018, Salt Lake health officials have spent over $347,000 on distributing naloxone kits through community agencies including public library branches. The county’s 18 libraries have handed out 1,500 kits, and their staff are also trained to carry and use naloxone. Meanwhile, the district attorney’s office has spent $53,000 to purchase and distribute kits to police departments in the county.
But Utahns who are not covered by these distributions would likely need to go to a pharmacy. Some pharmacies in the state offer the medicine without a prescription; local harm reduction group Utah Naloxone lists various pharmacies and ways to get the medication on its website.
Even with a prescription, however, naloxone can be expensive. It can cost $75 for a kit with two doses, and intramuscular injectable doses range between $20-40 each. An intranasal spray kit is even more expensive, at about $150.
These costs can be prohibitive for people on low incomes. In some scenarios, a patient may have taken so many opioids that one dose alone is not enough to revive them, and a second dose is required. For many people who use opioids regularly and perhaps chaotically, the cost of naloxone is far too high.
Jennifer Plumb, medical director of Utah Naloxone, told Filter that their key approach is to get naloxone directly to the public, cutting doctors, pharmacies and government bodies out of the equation.
Her organization distributes naloxone throughout the state, but its work is self-funded: The state government gives no money to support it. Utah Naloxone also helps distribute kits to the Salt Lake County libraries—in fact, they trained Tiffani King and gave her the kit she used to save the man’s life.
“We’ve really tried to find ways the general public can get naloxone in non-threatening ways,” Plumb said. “What our government can do is empower community organizations doing this work. Counties won’t buy the cheapest forms of naloxone and they’re not experts in this area. They should instead trust the people who are.”
She explained that if a community organization like hers received state funding, it could buy more kits and at a lower cost. Utah Naloxone would continue partnering with places like libraries or harm reduction centers where the people who most need naloxone can get it without worrying about being tracked by police or government officials.
Mindy Vincent, director of Utah Harm Reduction, agreed and told Filter that “the most important thing lawmakers can do is appropriate funding for naloxone.”
“Our organization has and continues to distribute more naloxone than any other organization in Utah,” Vincent said. They receive their kits from Utah Naloxone. “We are often asked to help get kits for law enforcement and others, who should always have access. We do a ton of public outreach and education, and people here know what naloxone is. Our state just doesn’t do enough to make it accessible financially.”
If the Utah state government provided funding for community-based naloxone distribution, there would likely be many more Tiffani Kings in the right place at the right time.
Photo via Next Distro.