Opioid overdoses on the Northern Neck

Cardinal News reports the rationing of the opioid overdose reversal drugs Narcan and naloxone by VDH in ‘This will cost lives’ Virginia Department of Health rations the cost-free distribution of Narcan kits as the number of fentanyl overdose deaths continues to climb.

According to the story,

Amid the latest surge in opioid overdose deaths in Virginia, the state has begun rationing the number of naloxone kits that local health departments and civic organizations are eligible to receive and hand out in their localities.

Narcan is the name-brand and naloxone is the generic.

To put the policy and funding decision in context of the Northern Neck and the broader Three Rivers Health District, the individual counties in Three Rivers Health District and the health district itself make up a small portion of opioid overdoses across the state. As is shown in the first table, patients residing in Three Rivers Health District represented 2% of opiod overdose ER visits across the state in July. King and Queen County and Mathews County had no visits and the rest had between one and four residents visit an Emergency Department (ED, commonly referred to as the ER), per the data in the second table.



This is not saying that the number of overdose-related ED visits is acceptable, because one is too many, but rather that this part of the state is faring better with regard to opioid use and overdoses than others. Of course, the data is imperfect and it should be expected that the real number of opioid-related overdoses is higher than what is reported.

An entirely separate question, though, is “How will people in Three Rivers Health District fare with the reduction of Narcan/naloxone kits available to addicts?”

From a public health and policy perspective, the cap, even if only temporary, is a bad decision. Across the state, opioid overdoses are increasing. At least locally, though, with less use and pressure on the system, pharmacies may be able to meet any increased need. Under the VDH Statewide Standing Order for Naloxone dated January 14, 2022 (PDF), pharmacists are among those who “may dispense naloxone. . . to a person to administer to another person believed to be experiencing or about to experience a life-threatening opioid overdose. . .” This means that individual prescriptions are not required to get naloxone at a pharmacy. It also means that the person asking for the naloxone does not have to use.



Data: ED Visits for Drug Overdose
Narcan and naloxone images: By NEXT Distro on Unsplash.