Families of Overdose Victims Call on Doctors to Prescribe Opioid Antidote

Andrew Kitchenman | July 22, 2014 | Health Care
Advocates warn lack of familiarity with medication, new provisions of law could mean more lives lost

Patty DiRenzo, whose 26-year-old son died of an overdose in 2010, is an advocate for the use of naloxone to help prevent more deaths from heroin and other opioids.
Patty DiRenzo said she knew there was a problem when her own family doctor wasn’t aware of a key provision of a law enacted last year that is intended to prevent overdoses from heroin and other opioids.

She said her doctor knew that her son Salvatore had struggled with addiction before dying from an overdose at age 26 in 2010, but she wasn’t aware that the new law allows doctors to prescribe the overdose antidote naloxone to patients struggling with addiction.

“I feel that every doctor in New Jersey needs to know that and needs to be able to do that with their patients,” said DiRenzo, a Blackwood resident.

She and other supporters of the law are calling for greater efforts on the part of state government and medical professional associations to promote the use of the drug as a means of reducing overdose deaths, which have been surging in recent years in the state and nationally.

The effort is having an impact. After DiRenzo contacted the New Jersey Academy of Family Physicians, it started including information about naloxone — also known by the trade name Narcan — in its newsletters and magazines.

There are signs that the law is savings lives. Police and emergency departments across the state have been training their personnel in how to administer naloxone. The drug has been used to reverse 40 ODs in Ocean County and 25 in Camden County, according to county prosecutor’s offices.

State Acting Attorney General John Hoffman issued a directive to police officers a year ago providing details about the law. DiRenzo would like to see a similar directive to all doctors, perhaps from the State Board of Medical Examiners, which licenses physicians.

“It’s just something that needs to be in the hands of anyone who has a child who’s struggling,” DiRenzo said of naloxone.

The Department of Human Services launched an awareness campaign about the law last year, which included a public service announcement and provided information to representatives of doctors, hospitals and insurers. Provisions of the law were also discussed at an all-day conference on opioids held in May by the Medical Society of New Jersey and New Jersey Academy of Family Physicians.

NJAFP government affairs director Claudine Leone said her group wanted to increase awareness of the issue. She added that many family doctors whose patients are at risk of overdoses were aware of the drug, including those in areas of the state that have been heavily affected by the increase in overdose deaths. Leone said her group wouldn’t object to the Board of Medical Examiners providing information about the law to doctors, but wouldn’t be inclined to support additional state regulations related to naloxone.

Dr. Kenneth Lavelle, who’s trained police officers across southern New Jersey in how to administer naloxone, said many doctors should learn more about the drug’s potential benefits.

“It’s incumbent on doctors to stay on top of things that would help their patients, but many do not,” Lavelle said.

He added that even when doctors do prescribe it, patients’ access could be delayed since few pharmacies stock naloxone. While the Ocean County Prosecutor’s Office lists five pharmacies that provide the drug, both Lavelle and advocates said access to the drug is scarce.

Kass Foster, whose son Christian died of an overdose in 1997, said personnel at local CVS and Rite Aid pharmacies told her that the drug wasn’t available. A spokesman for CVS said naloxone isn’t regularly stocked in its pharmacies, but can be ordered and dispensed to patients with a prescription. Rite Aid stocks naloxone based on local demand and makes it available within a day when a pharmacy doesn’t stock it, said a company spokeswoman.

Foster said she also had spoken with doctors who weren’t interested in prescribing the drug.

Foster said the problems with reducing overdoses extend beyond a lack of access to naloxone. She noted that the state has a shortage of inpatient addiction-treatment beds, adding that those who survive overdoses thanks to naloxone may not be able to receive the treatment they need.

“Once they are saved by the naloxone they should go right into treatment — you’re saving their life,” said Foster, a National Park resident.

The Drug Policy Alliance, which advocates for reform of drug laws, has worked with the NJAFP on the materials it will provide to its members. Alliance New Jersey Director Roseanne Scotti agreed with family members of overdose victims that doctors still must be educated about who could benefit from naloxone.

She described the NJAFP support “as a great first step” and said other doctor groups should consider holding panel discussions on the topic at their annual meetings. She added that the state chapter of the American College of Emergency Physicians asked the alliance to provide information at their conference.

Scotti said she’s hoping that national pharmacy chains will start stocking naloxone.

“Pharmacies never carried naloxone as a matter of course in the past because it wasn’t something you got a call for,” she said.

DiRenzo also said the growing use of naloxone by police officers shows why doctors should prescribe the drug more to patients.

“It’s just amazing to me,” she said of the overdose reversals that have been reported. The overdose victims “are getting a second chance. That’s why doctors need to inform their at-risk patients. It should be in their home. Doctors need to get on board like the police have gotten on board.”