I once watched as a woman came back to life. As an EMT in rural Columbia County, New York, many emergency calls involved opioid abuse and overdose. With the timely administration of Narcan (Naloxone) an unconscious person with a deathly pallor can be quickly resurrected. The result is rather astonishing: within five minutes the formerly unresponsive person will sit up and begin speaking.
Given that it is a prescription drug, Narcan is only available to a group of highly trained people; its wider use is restricted by state laws that prohibit administration by laypersons. Such regulation may be overly strict given that Narcan is a nasal spray with no side-effects.
Drug and particularly opioid overdose has become what former attorney general Eric Holder described as a “public health crisis,” with more Americans dying from overdoses than from car accidents. The chart below shows the alarming increase in heroin overdose deaths.
Source: The New Opiate Epidemic
The opioid epidemic has had an outsize effect on the populations of rural areas, with the rate of opioid overdose 45 percent higher than in urban areas. Narcan is the most effective antidote for rescuing those otherwise beyond help. However, a 2015 CDC study found that the rate of Narcan used by EMS staff in rural regions was only 23 percent higher than in urban areas.
The bill provides grants to police and fire departments to purchase Narcan and train staff in its administration, as well as a broad array of other tactics aimed at prevention and education, including expanded funding for mental health and addiction treatment.
Congress this week passed legislation entitled the Comprehensive Addiction and Recovery Act (CARA) that expands Narcan’s availability. This is a significant bipartisan achievement. The bill provides grants to police and fire departments to purchase Narcan and train staff in its administration, as well as a broad array of other tactics aimed at prevention and education, including expanded funding for mental health and addiction treatment.
Senate Majority Leader Mitch McConnell has been a particularly vocal supporter of the bill, with opioid addiction having an outsize effect on his largely rural home state, Kentucky. McConnell’s support has hinged on the fact that the bill offers no new funding for the issue. It also authorizes the attorney general, U.S. Department of Health and Human Services, and other government agencies to spend a previously allocated $400 million set aside for opioid-specific programs. This distinction of “no new funding” included in CARA was key in getting other fiscal conservatives in Congress on board.
Democratic presidential candidate Hillary Clinton has her own proposal to allocate $10 billion in new funding for drug addiction over the next several years. Senate and House Democrats fought hard to add hundreds of millions in new funding to combat opioid abuse beyond CARA’s authorization, but were unsuccessful.
Despite the lack of appropriations, President Obama will sign the measure soon, with many of his advisers publicly backing the bill. The director of the White House Office of National Drug Control Policy Michael Boticelli remarked:
“We know we need to do more, and I think that all of those components put forward in the bill are critically important to make headway in terms of this epidemic.”
Congress seeking to provide the life-saving Narcan to more groups is beneficial, but it’s important to remember that the problem does not start and end with overdose. The next administration should consider more inventive tactics that could help in the recovery from the pervasive perils and stigmas of opioid addiction, such as an earlier version of CARA that included a section forbidding the Department of Education to ask applicants for federal student aid about prior drug-related convictions, as well as by providing substantially more funding for prevention that could help save thousands of lives each year.