Contents of a naloxone reversal kit distributed by the NC Harm Reduction Coalition.
Contents of a naloxone reversal kit distributed by the NC Harm Reduction Coalition. Photo credit: Rose Hoban

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<p>The bill would make naloxone available to all of North Carolina’s 10 million citizens.

By Rose Hoban

Say you suspect your loved one is using heroin or some other opioid and you’re worried about them overdosing. If a new bill making its way through the state legislature becomes law, you’ll be able to walk into any pharmacy in the state and get access to a drug that blocks opiate overdoses.

SB 734 would allow state Health Director Randall Williams to write a “standing order” for naloxone, a drug that can reverse the effects of an overdose in seconds.

State Health Director Randall Williams works to convince the Senate Health Care Committee to pass a bill allowing freer access to the opioid reversal drug naloxone. Behind him stands Sen. Louis Pate (R-Mt. Olive). Photo credit: Rose Hoban

People who overdose on opioids die because narcotics suppress their body’s drive to breathe. But naloxone overrides that impulse so quickly that some have nicknamed it the “Lazarus drug.”

Essentially, Williams’ standing order would be prescriptive authority for the entire state, a move he called “bold.”

If passed, North Carolina would be only the third state to take this step, after Maryland and Pennsylvania.

“I think the issue we’re looking at today is in many ways the public health crisis of our time,” Williams told the Senate Health Care Committee on Tuesday morning.

He said that one in four autopsies now done by the state Chief Medical Examiner’s office is for an overdose death, and estimated that about one in four families knows someone who has been affected by opiate use.


Naloxone is distributed by harm-reduction advocates around the state to people who use heroin and prescription narcotics and to their family members and friends. That’s because an earlier law, SB 20, passed in 2013, allows people like workers from the North Carolina Harm Reduction Coalition to give out thousands of naloxone reversal kits.

To date, that organization has distributed more than 25,000 reversal kids and collected more than 2,650 confirmed reports of overdose reversals.

But Williams said he wants to go further.

“Because we have made Narcan – the commercial name of naloxone – so available to our first-responders – last year, for the first time ever – we had more people who were saved than actually died,” he told the committee. “There have been estimates that we could potentially save 500 of the 1,000 people who died last year if this was more available.”

After the Senate Health Care Committee meeting Tuesday, State Health Director Randall Williams makes a point to lobbyist John Del Giorno, who represents the pharmaceutical industry. Photo credit: Rose Hoban

Allen Dellapena from the Injury and Violence Prevention Branch of the state Division of Public Health said that naloxone would come in a syringe that has an attachment allowing someone to administer it into the nose.

“The nasal form is preferable,” he said. “It opens it up to families who would be more comfortable with nasal ingestion rather than the syringe.”

And, according to Williams, the naloxone will be covered by Medicaid and many insurers. And if it’s not, he said it retails for between $70 and $110.

Not disposable

The harm-reduction strategy has been met with enthusiasm and gratitude by people in the substance-use recovery community.

“I didn’t know I overdosed until I woke up in the ICU. I had a reversal done,” recounted Jesse Bennett, 38, who was at the legislature for a conference on substance-use recovery.

“At that point, I continued to use. But as a result of having the reversal, it kept me alive so I was able to engage into recovery when I was ready,” said Bennett, who has been free from illicit drugs since 2012.

Now he’s a student at NC State University, helping younger students stay drug and alcohol free. Bennett also works at Healing Transitions, a Wake County-based treatment center.

“Our ultimate end is to save lives and get people into therapy and help them,” Williams said, noting that the state still has to put resources into treating people with substance-use disorders.

“This is a long-term problem,” he said.

Each member of the committee expressed support for the bill, which passed unanimously. Now it goes to a Senate committee before heading to the Senate floor, probably later this month.

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