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Overdose numbers decreasing; Narcan maker says W.Va. cutting back on opioids

West Virginia has the highest age-adjusted rate of drug overdose deaths involving opioids, according to the National Institute on Drug Abuse.

In 2017, there were 833 drug overdose deaths involving opioids in West Virginia — a rate of 49.6 deaths per 100,000 persons. This is double the rate in 2010 and three times higher than the national rate of 14.6 deaths per 100,000 persons.

But conditions are improving in the Mountain State, said Thom Duddy, vice president of communications of Emergent BioSolutions, a Gaithersburg, Md.-based biopharmaceutical company whose product line includes Narcan nasal spray, a naloxone-based drug used to reverse the effects of an opioid overdose.

“West Virginia is doing a great job,” said Duddy, who stopped in Morgantown this week following a business trip to Charleston. His daughter, Olivia, is a sophomore at West Virginia University, where she is studying business administration.

The good news for West Virginians is that less prescriptions are being written for opioid pain relievers in the state because more people are paying attention, said Duddy, who is quick to add there is still a long way to go before the state — or even the country as a whole — will be able to make significant headway in curbing the epidemic.

Duddy said more than 36 million nationwide are still considered at risk for opioid addiction. A person can get addicted to opioids in five days.

In March, West Virginia law makers passed legislation allowing pharmacies to dispense naloxone without a prescription. This means a person can walk into a pharmacy and purchase Narcan. That law went into effect June 10.

“Insurance covers 97% of the cost,” he said.

And that is a good thing, too. The Washington Post recently examined the Drug Enforcement Administration’s database that tracked the sale of every single pain pill sold in the U.S. between 2006 and 2012.

The database shows 25.96 million prescription pain pills were supplied to Monongalia County, with the Walgreen pharmacy in Morgantown receiving the highest number of pills. During the same time frame, 5.9 million pills were supplied to Preston County. Kingwood Pharmacy in Kingwood received the highest number of pills, according to the database. Marion County, meanwhile, received 12.68 million pills. The Walmart pharmacy in Fairmont received the largest number of pills.

West Virginia, as a whole, received 853.48 million pills during those seven years. Strosnider Pharmacy in Kermit, Mingo County, received the largest number of pills at 13.16 million, the database said.

The drug and the device

Emergent BioSolutions manufactures Narcan in an applicator that can fit in the palm of a hand. It dispenses the naloxone in a nasal spray that is absorbed into the membranes and then into the blood stream.

Naloxone itself has been around since the early 1960s when it was used to treat constipation caused by chronic opioid use. A decade later the federal Food and Drug Administration approved the drug to treat opioid overdoses by intravenous or intermuscular injection, the Centers for Disease Control and Prevention in Atlanta said.

The drug, which takes effect within two to five minutes of being administered, blocks the effects of opioids on the brain and restores both consciousness and breathing. It only works if a person has opioids in his or her system and it is not addictive, Duddy said. There are almost no side effects.

Narcan usually comes in two doses, in case a second is needed. The cost of the drug — metabolized faster than opioids — is $37.50. It is becoming more typical for everyday people to carry Narcan because so many know someone who abuses opioids, Duddy said.

“We have never raised the price,” he said. “There is no needle and no assembly. … It is a standalone device.

“Most people don’t like needles.”

Getting help

Physicians in West Virginia are prohibited from prescribing opioids for more than four days without an emergency or urgent care setting. But if a patient is in an urgent care setting and additional need is determined, seven more days can be prescribed.

Dentists or optometrists may not issue more than a three-day opioid supply at any time, the state said.

The West Virginia Bureau for Behavioral Health and Health Facilities leads the state’s efforts to increase the awareness and use of medication-assisted treatment programs.

Duddy said while Narcan is not addictive, going through opioid withdrawal can be unpleasant and the time it takes the body to recover will vary from person to person.

Symptoms of opioid withdrawal can include the inability to sleep, excessive sweating, anxiety, muscle aches, abdominal cramping and diarrhea, blurry vision, rapid heartbeat and high blood pressure. In many cases, the person going through withdrawal will relapse.

“These people are trying not to be sick,” Duddy said.

“Less people are dying, but we’re just scratching the surface.”

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