By SCOTT MCKIE B.P.
ONE FEATHER STAFF
In an effort to reduce opioid overdose deaths in the community, the Cherokee Indian Hospital Pharmacy has begun distributing naloxone, sometimes referred to by the brand name Narcan, kits free of charge to the public.
“Patients who are eligible to receive medications from the Pharmacy only need to check-in at one of the front windows to request a kit,” said Jason White, Cherokee Indian Hospital chief pharmacist. “The pharmacist does a chart review and an order for the kit is placed and processed under a standing physician order. We require and provide education for the patient on how to use the kit. In the state of North Carolina, patients do not need to see a doctor to procure a Narcan kit from a pharmacy, and we take the same approach at CIH Pharmacy.”
White said there aren’t limits per se on the number of kits a person can request. “There isn’t a hard cap. We dispense one kit at a time. We recognize that the meds expire and need to be replaced occasionally. Patients/individuals should only need one at a time and are encouraged to not hesitate to use it if needed. We will replace used, lost, or expired kits when needed.”
According to the National Institute on Drug Abuse (NIDA), “Naloxone is a medication designed to rapidly reverse opioid overdose. It is an opioid antagonist – meaning that it binds to opioid receptors and can reverse and block the effects of other opioids. It can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications.”
Narcan provides naloxone in a nasal spray system. “Narcan nasal spray is a prefilled, needle-free device that requires no assembly and is sprayed into one nostril while patients lay on their back,” NIDA information states.
On the costs of the Narcan program at Cherokee Indian Hospital, White noted, “We are able to procure kits at about half the cost of what other pharmacies pay for them. This amounts to about $30 per patient who requests a kit. Narcan kits are funded through the same sources we use to provide medications to our patients who are eligible and utilize CIH services.”
The FDA approved the use of Narcan nasal spray in November 2015. “Combating the opioid abuse epidemic is a top priority for the FDA,” Stephen Ostroff, MD, then-acting FDA commissioner, said at the time. “We cannot stand by while Americans are dying. While naloxone will not solve the underlying problems of the opioid epidemic, we are speeding to review new formulations that will ultimately save lives that might otherwise be lost to drug addiction and overdose.”
NIDA reports that from 1996 to 2014, “at least 26,500 opioid overdoses in the U.S. were reversed by layperson using naloxone”.
“We are in contact with the Pharmacy about their efforts to distribute naloxone to the community,” said Freida Saylor, Analenisgi director. “In conjunction with the Pharmacy, we have taken a proactive stance to preserve life when at all possible through policy, prevention and education. We are in support of the distribution as we have seen the implications of the opioid use and overdose in the community. We hope to continue to work with community members to broadening these efforts as time goes on.”
The Cherokee Nation has taken the fight against opioids to court. First filed in April in the District Court of the Cherokee Nation, the suit (Cherokee Nation v McKesson Corp.) was filed in federal court on Friday, July 21.
The original petition filed by the tribe names McKesson Corporation; Cardinal Health, Inc.; Amerisourcebergen; CVS Health; Walgreens Boot Alliance, Inc.; and Wal-Mart Stores, Inc. as defendants and states, “Today in the Cherokee Nation, as elsewhere in the country, prescription opioids are more deadly than heroin.”
The petition goes on to state, “The brunt of the epidemic could have been, and should have been, prevented by the defendant companies acting within the U.S. drug distribution industry, which are some of the largest corporations in America. These drug wholesalers and retailers have profited greatly by allowing the Cherokee Nation to become flooded with prescription opioids.”
The lawsuit alleges that an estimated 845 milligrams of opioids were distributed throughout the Cherokee Nation in 2015. “That amount would average out to be approximately 703 milligrams per Cherokee Nation citizens within those counties. Obviously most people do not take opioids, so this per capita average can be spread across the approximate estimate of Cherokee Nation citizens who actually use opioids to give a more accurate picture of the level of opioid diversion in the Cherokee Nation.”