In Wichita as well as elsewhere in the nation, the opioid epidemic and fentanyl are growing scourges, claiming more lives each year. An important tool for saving lives is naloxone.
Administered by injection or nasal spray, it can quickly reverse the effects of an overdose and prevent deaths.
Wichita harm-reduction activists are hopeful the Food and Drug Administration’s recent decision to sell Narcan, a brand of nasal spray naloxone, without a prescription over-the-counter will make the drug more accessible to people who need it – but when and how it might be available is not yet clear. The activists routinely distribute thousands of Narcan kits a year, and demand keeps rising.
Only the nasal spray has been approved for OTC distribution.
How quickly Narcan is available in local pharmacies depends on manufacturers and suppliers, the FDA said in its press release announcing its decision.
In the interim, naloxone remains available locally through two harm-reduction activist groups, Developing Caring Communities Committed to Action (DCCCA) and a local effort called Safe Streets Wichita.
DCCCA’s program is statewide, funded through by the Kansas Substance Abuse and Mental Health Services Administration. DCCCA mails naloxone kits across the entire state to people who request them, based on availability. Here is how you submit a request.
In Wichita, Safe Streets hosts regular events to teach people about drug harm-reduction measures including naloxone, distribute it in the community and advocate for laws around harm reduction and health care. Naloxone can also be registered from them.
Fentanyl in Wichita
In 2019, just 28 overdose deaths in Sedgwick County were attributed to fentanyl. In 2020, the number climbed to 90 deaths; it rose to 160 in 2021. So far, 219 fentanyl deaths have been tallied in 2022, according to Sedgwick County Sheriff Jeff Easter.
But that 2022 number is not final. A surge in overdose deaths has created a backlog for the Sedgwick County Forensic Science Center.
Chrissy Mayer is the DCCCA’s chief community-based services officer. She has watched the demand for naloxone go up, especially in Sedgwick County, which requests more than any other Kansas county.
DCCCA measures their distribution of Narcan by their fiscal year that starts in October and ends in September. For their fiscal year that ended in 2021, they sent 1,322 naloxone kits to Sedgwick County. The next year, they sent 4,353 kits.
Johnson County is the second highest requester, with 1,496 kits requested in the fiscal year that ended in 2022.
“The demand is very much there,” Mayer said. “Sedgwick County is getting the bulk of our naloxone without a doubt.”
Safe Streets similarly distributes a lot of naloxone. They are required by their funding through the city to distribute at least 800 kits a month. Last month they gave out 1,565 kits to residents in Sedgwick County.
What is Narcan and how does it help?
Narcan is the name of one brand of naloxone hydrochloride nasal spray. It is produced by Emergent Biosolutions. Narcan’s active ingredient is naloxone, which is an opioid antagonist. Opioid antagonists work by binding to receptors to block and reverse opioid effects.
To use Narcan, all someone needs to do is insert the pre-packaged spray nozzle into a person’s nose and squeeze the bottom. For better results, place the person on their back and tilt their head back. If the person is still unresponsive after two or three minutes after the first dose, a second one can be administered.
But nasal spray isn’t the only form of naloxone. Naloxone also commonly comes in an injectable liquid from. This is the kind distributed by Safe Streets.
Narcan over-the-counter in Wichita
Representatives from DCCCA and Safe Streets agree that the best part of the FDA approval is accessibility. Providing Narcan over-the-counter means that it will be available not only in pharmacies but convenience stores, shopping marts and other frequented businesses.
Aonya Barnett, program director of Safe Streets, said she is happy to see this FDA approval finally happen.
“We have seen the slow response to this, Kansas’ slow response to fentanyl, so I am not here to gatekeep help,” Barnett said. “Politics is politics but people are saying right now that they need it.”
Kansas has not passed a bill to help curb the opioid epidemic since 2017 when they voted to allow first responders to carry Naloxone. A Beacon analysis shows Kansas has only adopted one policy recommended by local and national advocacy programs that could help curb opioid overdoses, and that policy is allowing naloxone to be used without a prescription.
The unintended consequences of over-the-counter Narcan in Wichita
Ngoc Vuong, a doctoral student studying community psychology at Wichita State University who helped start the naloxone distribution at Safe Streets, is also happy to see this step happen at the federal level but is anxious about how it may affect funding.
“I do not want them to see this as a silver bullet,” Vuong said.
Safe Streets gets a large portion of its funding to distribute naloxone from the city of Wichita. Vuong’s fear is that the city will see over-the-counter naloxone as providing the access needed to that drug and decrease its funding for Safe Streets when their current grant has ended.
Mayer agrees that the fear is founded but doesn’t see that happening for free naloxone programs at the state or local level.
“If Narcan finally gets here and it costs as low as 10 dollars, 10 dollars is still a hurdle to overcome for some,” Mayer said. “So we will still need to give that support.”
Vuong hopes that local and state politicians see the need for their programs so that funding isn’t pulled after Narcan is in stores.
What’s next and how to get involved
Vuong and Barnett agree that the FDA’s move is only a first step. With only one Narcan supplier approved for over-the-counter distribution, there is no competition to drive prices lower.
Also, there are other harm-reduction options that Kansas can enact to prevent more overdose deaths from occurring such as safe-use sites.
A safe-use site is a place where someone can use drugs in a controlled environment and be helped by staff by testing the drugs, providing medical care and directing to resources to curb addiction. Barnett says that other communities across the United States have successfully created safe-use sites and Kansas should be next.
The purpose of harm reduction is to ensure that people suffering addiction stay alive until they can get into rehab programs and work toward recovery. Capacity is limited and waits for entry can sometimes take weeks. Once people get help, 3 of 4 people who suffer addiction eventually recover, according to the Centers for Disease Control.
Barnett also wants Kansas to legalize fentanyl test strips – something that has been done locally in Wichita.
If someone wants to get involved with Safe Streets to help with naloxone distribution or increasing awareness for harm-reduction policies, they can find the contact information on the Safe Streets website.
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