As medicine and law enforcement fight different parts of a nationwide battle against the abuse of prescription opioids and the popularity of heroin, they’ve discovered a terrifying effect of new synthetic drugs used to make heroin cheaper and more powerful. People who have taken fentanyl or carfentanil sometimes need multiple doses of the life-saving drug naloxone to be revived, and the drug is expensive.

Naloxone works by blocking the effect of opioid drugs, effectively reversing an overdose and reviving patients. The price has edged up recently, but the problem, Bloomberg News reports, is that local governments are just using more of it.

Bloomberg cites one company that tracks drug sales nationwide, which found that in 2011, there was around $21.3 sold of all brands of naloxone nationwide. In 2015, before strong imported fentanyl began spreading nationwide, that amount hit $81.9 million.

Saving lives and money

There are cheaper solutions available to some professionals. Like with the homemade EpiPen kits that some emergency medical services crews create with pre-filled syringes of epinephrine, some ambulances fill their own nasal injectors with naloxone instead of buying pre-filled nasal injectors designed for people who don’t administer the drug often.

One city councilman in Ohio proposed putting drug abusers on a “three strikes” system, partly because of the expense to first responders of naloxone treatment. When some patients need as many as nine doses of the stuff to come around, and there are hundreds of overdoses in one small city every year, it adds up. The main thing that led the councilman to drop the plan was the potential legal repercussions of having emergency personnel shrug and leave repeat overdose patients to die.

If President Trump follows the advice of his opioid crisis commission and declares a national emergency, that will allow the U.S. Department of Health and Human Services to negotiate with drugmakers for steep discounts on doses of naloxone that the federal government would distribute.

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