WNPR

Demand for Naloxone Varies, as Number of Pharmacists Prescribing It Grows

Oct 3, 2016

Patients and caregivers seeking the opioid-reversal drug naloxone can now get the medication without a doctor’s prescription. That’s thanks to a state law that went into effect one year ago allowing pharmacists to prescribe and dispense the drug. 

WNPR traveled around Connecticut to speak with pharmacists who got certified to learn why they did it, and what demand for naloxone has been like.

Visels Pharmacy sits on a street corner in New Haven, in the same neighborhood where, on one day last summer, 17 people overdosed, and three people died from opioids.

On its door is a sign, a bright advertisement for naloxone, also known as Narcan -- a medicine that can reverse the effects of an opioid overdose.

Ed Funaro, Jr., is a pharmacist there. He's certified to prescribe the drug, one of nearly 1,000 pharmacists in the state who can do it. That means you can walk into his store, ask for the drug, and get it -- without a note from your doctor.

"You’d think that, well, maybe people were asking, but in reality -- no," he said. "And I still, to this day, haven’t seen a huge demand."

Today, as more and more pharmacists get certified to prescribe naloxone, demand is still spotty. Not everyone is aware of the drug, which -- depending on the kit -- can range in price from about $150 to several thousand dollars.

And not every store has a pharmacist who’s certified to prescribe it. 

"One of the really important messages we're trying to get out to people is call your pharmacy, ask a lot of questions about it, and if you're not getting an answer or people seem unsure, ask for a pharmacist," said Rodrick Marriott, director of the drug control division for the state Department of Consumer Protection.

Statewide, Marriott said about 320 stores have a pharmacist on staff who can prescribe and dispense naloxone, including major chains like Rite Aid and CVS. He said Walgreens is currently working with the state to get its pharmacists certified, and in the meantime, lots of independent stores have already gotten on board.

Credit Patrick Skahill

Over at Granby Pharmacy, Jean Keating said she’s only written one prescription, but still said it’s important she’s certified, because heroin is in her community.

"We’ve had one patient that we knew very well, who he ended up dying of a heroin overdose," Keating said. "There’s another person our community, who -- he had a son the same age as my son, and he died of a heroin overdose -- so if I had the opportunity to save his life, that little boy would still have a father."

At Petricone’s Torrington Pharmacy, in the largest city in Connecticut’s Northwest Corner, heroin is in the community, too.

Joseph Petricone, Jr., a pharmacist there, said demand for naloxone has been increasing since he got certified. "We’re getting in a few a week," he said. "Actually, as a matter of fact, now I’m starting to see a couple people, unfortunately, coming back for their second kit."

But Petricone said everyone who should have naloxone still isn’t asking for it -- in part because of stigma.

Jill Fitzgerald, a pharmacist and teacher at the UConn School of Pharmacy, which offers one of the online courses used to certify pharmacists, said that means sometimes, pharmacists need to start the conversation. "It’s not just for addiction or for patients who are using opiates inappropriately, but actually -- for patients who have a known and legitimate medical use for these products," Fitzgerald said.

That can include patients on prescription painkillers.

Jacqui Murphy, at Hancock Pharmacy at Long Wharf in New Haven, is located near a substance abuse clinic, so she writes a lot of prescriptions for naloxone -- about three to five per week. And while she said lots of people in treatment request the drug, some of her job, she said, involves education of people on prescription opioids, too. Like a discussion she had with a grandmother who keeps her pain medication in the house, while taking care of her two grandchildren.

"God forbid they get into your stuff. And she goes, 'Oh my God, I never thought of that possibility,'" Murphy said. "And that's what I usually tell people -- it's not that I think you're going to overdose, I'm concerned about someone coming into your house and overdosing in your house."

Back in the New Haven neighborhood where 17 people overdosed on one day this summer, pharmacist Ed Funaro said even though demand at his pharmacy isn't great, he still keeps three naloxone kits in stock at any time, and can have more kits in stock within 24 hours if demand spikes.

"If someone is in a circumstance -- again, family member, loved one, whomever -- has an opioid overdose, well now, you have a product readily available," Funaro said.

Funaro said he'll sit down with anyone who requests a kit, or even anyone who is curious about naloxone, to explain to them the importance of the drug, how to use it, and how it could save the life of someone suffering from an opioid overdose.

WNPR's Opioid Addiction Crisis Reporting Initiative is supported by Hartford HealthCare Behavioral Health Network's MATCH Program.