Shumlin: all Vermont pharmacies can now sell naloxone without a prescription

In the face of a recent spate of heroin overdoses and growing fears that, in addition to fentanyl-laced heroin, a more dangerous version of the drug called carfentanyl is poised to move into the state, Gov. Peter Shumlin and Health Commissioner Harry Chen, M.D., announced Aug. 25 that the Department of Health has issued a standing order for the opioid overdose rescue drug naloxone (brand name Narcan®) for all of Vermont. This allows any pharmacy to dispense the life-saving drug to anyone–without a prescription.
In addition, the governor said he was pleased that Walgreens will begin offering naloxone without a prescription to customers beginning Sept. 1, and has installed a safe medication disposal kiosk in its South Burlington store that allows individuals to safely dispose of unwanted medication year-round at no cost.
“This has been an even more dangerous and risky summer for people who are addicted and who unknowingly buy drugs laced with strong, potentially deadly, additives that cause them to overdose,” Gov. Shumlin said at a news conference at the Health Department. “It’s vitally important that we make sure naloxone is in the hands of anyone who may be in a position to save lives and give these Vermonters a second chance at beating their addiction.”
“By making naloxone available without a prescription, we are making it easier for families and caregivers to help their loved ones by having it on hand in case it is needed,” said Brad Ulrich, Walgreens regional vice president. “As a pharmacy we are here to help people and are committed to making it easier to dispose of unwanted medications in the communities we serve.”
“Clearly the aim of making naloxone more widely available is to prevent deaths,” said Dr. Chen. “This is risk reduction for people who are using. At the same time, we’re working on all fronts to help those who are addicted to get into treatment, to stay in recovery, and to prevent addiction in the first place.”
The standing order signed by Dr. Chen on Tuesday is designed to ensure people who are addicted to opioid drugs, as well as their friends and family members, have easy access to naloxone hydrochloride (Narcan®), in the event of an overdose. The order also allows insurers and Medicaid to cover the cost so people who want to have the drug will not have to pay out of pocket.
Dr. Chen noted that the daily average number of patients receiving naloxone by emergency medical services has gone up from 1.2 last year to 1.8 this year, but since June 1, that number is up to 2.2 patients per day. Law enforcement reports that heroin investigations are up 70 percent over the same time last year.
Fentanyl is a synthetic opioid that is about 50 times more powerful than heroin and is sometimes added to heroin. In Central Vermont, nine overdoses–one fatal–linked to fentanyl-laced heroin were reported during a single weekend earlier this month. Carfentanyl, a synthetic drug 100 times more powerful than fentanyl, is poised to move into the state, according to law enforcement.
According to reports to the Health Department, naloxone has been used at least 241 times in 2016 through June 30 for people perceived to be overdosed on heroin, fentanyl, prescription painkillers or a combination. For that same time period, a total of 44 deaths from these drugs have been confirmed by the Health Department.
“Clearly, we would have lost more Vermonters if naloxone had not been available,” Gov. Shumlin said.
In addition, the Health Department is establishing a statewide unused prescription drug disposal program to provide for the safe disposal of unused and unwanted prescription drugs. In the near future, safe drop-off points and access to drug take-back mailers will available throughout the state.
The Health Department is also in the process of enacting regulations concerning the prescribing of opioids. These regulations will ensure that doctors who treat for pain assess alternatives to opioids and, when opioids are prescribed, that they are prescribed in the smallest effective doses for the shortest period of time.
The Vermont Prescription Monitoring System is currently sharing data on controlled substances prescribed to Vermonters with New York, Massachusetts and Connecticut, and the Health Department expects New Hampshire data to be available this fall.
Earlier this week, Sen. Patrick Leahy, law enforcement and the U.S. Attorney’s Office announced the award of $1.4 million to hire and train five new detectives to join the Vermont Drug Task Force. The number of task force members increased from 19 to 24.