As the Biden administration calls for overdose antidotes to be provided closer to where illicit drugs are consumed, there is a chronic shortage of affordable versions of the drugs. Harm-reduction organizations that give clean needles and medical care to drug users need cheap reversal treatments in greater quantities and closer to where drugs are taken as the synthetic opioid fentanyl permeates the drug supply and overdose deaths reach record highs. Community groups are more likely than health care providers to get naloxone to someone experiencing an overdose in time. Naloxone, a drug that reverses or blocks the effects of opioids on the central nervous system, comes in nasal sprays and injectables. Nasal sprays such as Narcan cost up to $125 for two doses and are often stocked by first responders and at health care facilities. Groups working with drug users say that puts them too far away in the moments after an overdose when they are most effective.
“Fentanyl is really fast,” said Derrick Smith of Harm Reduction Michigan in Rapid City, which distributes naloxone. “In the old days of heroin overdoses, someone could be unconscious in an hour and you could still bring them back. I’ve seen people die in minutes.” Groups like Harm Reduction Michigan say the nasal sprays are too expensive for them to buy in large quantities. A coalition of groups banded together a decade ago to negotiate a deal with Pfizer to buy below-market, injectable naloxone at under $5 a dose. Harm-reduction groups say they also prefer the injectable version because it allows for more control over the dosage of a drug that can trigger acute withdrawal. With supplies tight, groups have traded doses for other goods like needles. Others used expired, sprayable doses from public stockpiles for lack of other options. Groups are lobbying for state and local governments to shift funding from buying nasal sprays for public services to distribute in emergencies to a strategy of making more injectable doses available nearer to where people are using drugs.