Opioid deaths fell by a third after states starting selling naloxone over the counter, study finds

US states that passed laws to allow pharmacists to sell the opioid overdose reversal drug, naloxone, to customers without a prescription saw overdose death rates fall by up to 34 percent, a new study reveals.

Expanding access to naloxone is one of the five key strategies laid out by the Department of Health and Human Services (HHS) in the hopes of combating the ongoing opioid epidemic. 

As of 2016 (the most recent data included in the new study), 47 US states had passed laws to improve access to the drug. 

But only nine had made it legal for pharmacists to give out naloxone with out prescriptions, and those states saw far and away the most dramatic reductions in overdose deaths, the new RAND Corporation study reports. 

Now, Washington DC and all US states except for Wyoming and Hawaii permit naloxone to be sold over-the counter, and the new study suggests the shift will help reduce drug deaths. 

Naloxone has earned the nickname the Lazarus drug because it can so effectively save the life of a person who has taken an otherwise fatal dose of heroin, fentanyl or prescription opioids. 

In the last 14 years, the number of annual overdoses has quadrupled. 

And in their wake, distribution of naloxone has surged, too, as the drug’s prevalence continues to show the most tangible promise for curbing the deadly effects of the drug epidemic. 

More than 26,500 lives were saved from opioid overdoses by lay people with naloxone beween 1996 and 2014, according to data from the CDC.  

Since 2005, more and more states have passed laws to make naloxone easier to access. 

Now, nearly every US state has made some measure to that effect, but only a handful permitted the life-saving shots and sprays to be sold over the counter in 2016. 

The RAND Corporation researchers examined data on how fatal overdose rates shifted from state to state after various naloxone access laws.

Laws that allowed doctors to issue ‘standing orders’ for naloxone – meaning they could call in prescription that the patient could essentially pick up at will, but still requiring the patients to be assessed by a doctor before they’re allowed the drug – were not followed by any significant changes in death rates. 

But in the nine states that had laws making naloxone an over-the counter drug, death rates fell considerably, but it took some time for the shift to be evident. 

In the first year after each state adopted over-the-counter measures, rates were about the same, but in the second year after these laws were adopted, researchers saw an average of 27 percent declines in opioid overdose deaths. 

And the following year, over-the-counter naloxone state shad 34 percent lower rates of overdose deaths.  

‘This is strong evidence that greater use of naloxone can help reduce opioid-related deaths,’ said David Powell, a RAND economist and study co-author. 

His co-author, Rahi Abouk, who was lead investigator, said: ‘These findings highlight the importance of coupling naloxone access laws with effective interventions and connections to treatment for patients seen in emergency departments for overdoses.  

‘This is the location where such programs may be the most effective.’ 

Now, naloxone is available over the counter in almost every state, and the new study suggests that in the coming years, its impact may help to curb staggering opioid overdose death rates in the US.