Soteria Screening


States Struggle to Budget for Repeat Overdose Treatments

There is no doubt that the opioid epidemic has been hitting all 50 states in recent years, and hitting them hard. Ohio has raised a point that is rather relevant and also incredibly sad: with the number of overdoses that have been occurring every day, how exactly do you budget for that? Where you do call it quits on administering Narcan to people who are going to continue to overdose time and time again when you could be giving the drug to others who may actually get help and stay clean?

During the first four months of last year alone, western Ohio dealt with nearly 100 cases of fatal overdoses. Hospitals are overwhelmed, morgues are running out of room for all of the new bodies that have been coming in, and local officials in several states are struggling to find the funds necessary to pay for reviving, rehabilitating, or – in the worst case – burying those who overdose. The problem is not that officials do not want to continue treating overdose cases; they're just simply running out of money with which to do that.

Some state and local officials are suggesting a kind of "tough love" approach by forcing drug users to pay rising medical costs, or even limiting the number of times a first responder is permitted to save the same person's life. This is because the demand for opioid antidote medications like Narcan only continues to grow, as it often the only thing that can keep someone's overdose from turning fatal, and it becomes harder to pay for the more people need it.

To put this into perspective, just two doses of Evzio, an injectable form of Narcan, costs $4,500. This cost has risen from $690 in 2014. To say that is a significant increase is a massive understatement. Other versions of the drug, like the nasally administered version, cost much less – $70 to $150 per dosage – but that still adds up when you consider the number of people that need a shot of it across the country in any given day.

Compounding the costs even more, as the opioids get stronger (like fentanyl and carfentanil), so too must their antidotes, and so multiple doses of Narcan may be needed to revive patients in some cases. This certainly seems futile when a drug user goes back to using drugs within days, or sometimes even hours after being brought back to life.

First responders in Ohio say it is not uncommon for those who have overdosed before to have been revived at least six times or so. Officials and residents are now asking themselves how to help those that seemingly cannot help themselves. Scott Gehrin, the head of the Community Health Alliance in Butler County, says that while at least half the population have been affected by the epidemic and understand that addiction is a disease, "it’s very easy for [the other side] to say these people are just a burden."

Maine's governor, Paul LePage, has lobbied for overdose survivors to pay for their own Narcan. He has also vetoed a bill that proposed victims having a wider access to Narcan, however the legislature voted to override him.