Just after the 2015 legislative session, Texas Governor Greg Abbott vetoed a bill that would have given limited criminal immunity to good Samaritans who called 911 to report a drug overdose. That wasn't a very nice thing to do — something we were more than happy to point out. The bill passed both the House and Senate with overwhelming majorities, but the governor said he felt the bill would enable "habitual drug abusers and drug dealers."
At the time, things didn't seem great for Senate Bill 1452, another bill meant to keep people alive. Opponents of the bill, which expands access to naloxone, a drug that counteracts the effects of opioid overdose, said Abbott's signing it would enable drug users. Having access to life-saving medication, the bill's opponents said, would keep users from wanting to quit.
Surprisingly, Abbott signed the bill in late June. September 1, naloxone became more widely available.
Previously, a doctor could prescribe the drug only to patients who the doctor felt might be at risk for an overdose. Now, there's a wider range of people to whom the drug can be distributed. Anyone in a position to administer naloxone to someone who's overdosed can have a standing order issued to them by a doctor. The standing order allows the prescribed naloxone to be picked up from the pharmacy by anyone who meets a set of criteria established by the prescribing doctor. Any organization or person who's been given a standing order by a doctor can store and distribute naloxone, without civil or criminal liability.
Naloxone is not an intoxicant — you can't get high off of it — all it does is reverse the effects of opioid overdose. It can be administered as a nose spray or straight into a muscle with an EpiPen like device. Since 1996, when the first naloxone take-home program began, the Harm Reduction Coalition reports that more than 26,000 drug overdose-reversals have occurred thanks to naloxone.
“Thousands of fatal overdoses occur every year — but this report shows that we can reduce overdose deaths by giving drug users and their families access to naloxone,” Eliza Wheeler, a program manager at the Harm Reduction Coalition, which runs model overdose prevention programs in New York City and San Francisco said in June as her organization's numbers were released. “We need to recognize that take-home naloxone programs are highly effective, fund them accordingly, and support the life-saving work that they do.”
In Texas, the Texas Overdose Naloxone Initiative helped lead the effort in support of SB 1452.
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"It's pretty rare that you have a public health epidemic that we can do pretty simple measures to dramatically curb it," TONI co-founder Mark Kinzly says. "You'll probably never eliminate [the risk of drug overdose], but, boy, we can sure make a huge difference."
Kinzly knows the benefits of naloxone. It's saved his life twice. It's important, he says, to educate doctors as to what they can and can't do under the new law so that Texans who need access to the life-saving medication can get it.
"Often times when entities like state governments are going to be involved in the rolling out of something [like expanded naloxone access], the process gets bogged down in real bureaucratic, red-tape stuff," Kinzly says. "The message is just now getting out."
TONI is working with the Texas Medical Association to train the organization's member doctors. Pharmacists are being targeted as well. TONI currently provides forms to pharmacists to give to patients who come in with an opioid prescription. If the person filling it wants access to naloxone, the pharmacist can fax the form to a doctor, who can sign off on distributing the drug.