Push for Naloxone to be readily available at bars, nightclubs

HONOLULU (KHON2) — On Wednesday, March 29, the Food and Drug Administration approved over-the-counter sales of Naloxone nasal spray. This could allow the potentially life-saving medication that is used to reverse opioid overdoses to be easier to access.

Naloxone is a medication that was created to reverse opioid overdoses. It comes in an injectable version and a nasal spray version.

Until the FDA’s approval, the nasal spray was only available with a prescription from a physician, a pharmacist or a local agency authorized to dispense the medication.

The four-milligram doses that each package contains will be on shelves at drug stores, grocery stores, gas stations and online.

“Narcan saves lives. With the widespread proliferation of synthetic opioids in our community, it is more important than ever that we make this life-saving resource as accessible as possible,” said Councilmember Tyler Dos Santos-Tam.

Dos Santos-Tam is in the process of making Naloxone available in places where it is needed most — in bars, nightclubs and other venues.

“Bill 28 is about keeping the public safe. It is about using every tool at our disposal to prevent accidental overdoses,” explained Councilmember Dos Santos-Tam.

The Hawaiʻi State Department of Health said that from August 2017 to August 2018, there were 59 deaths in the State from opioid overdoses. They said that in 2020, that number had increased to 274. That is a nearly 500% increase.

“We know that drugs and alcohol don’t mix, and certain venues are more high risk. So, what we did was we looked at all of our liquor licensees, and said, ‘those who are serving liquor and alcohol on premises, that is our bars or nightclubs, those should, you know, be carrying Narcan to make sure that their patrons are safe’,” added Councilmember Dos Santos-Tam.

Robbie Baldwin, who owns a popular nightclub in Chinatown, weighed in on the need for Naloxone access.

“Overdoses happen, especially when mixed with alcohol. Our bars and nightclubs must be prepared for every contingency. I am grateful that the City Council is taking on this important issue. This bill will protect businesses, patrons and the public at large,” said Baldwin.

In a significant move to combat the growing fentanyl problem in the United States, the Food and Drug Administration (FDA) has approved the sale of Narcan or Naloxone over the counter without a prescription.

The nasal spray, which has been used by the Honolulu Emergency Medical Services (EMS) for years, has the potential to save even more lives.

Dr. James Ireland, Honolulu Emergency Services Director, explained the importance of Narcan in reversing the effects of an overdose.

“If people do have family or friends that are struggling with addiction, opioid addiction which is narcotics, oxycodone, oxycontin, heroin and now fentanyl unfortunately very powerful narcotics; and if you overdose, you actually can stop breathing. The Narcan that’s administered nasally will reverse that in a minute, and people will wake right up,” explained Ireland.

Though Narcan is easy to administer and comes with instructions, Dr. Ireland said it’s crucial to call 911 in the event of an overdose. He noted that even if a person wakes up after Narcan is administered, they may still have narcotics in their system and may need another dose.

Over a 12-month period ending September 2022, about 42% of the 1,044 people who received Narcan showed improvement, according to Honolulu EMS data. Habilitat Executive Director Jeff Nash believes that a near-fatal overdose can sometimes provide the motivation needed to seek help.

“I’ve seen a lot of times where someone has a near-fatal overdose, and they survive it. And, sometimes, that is the motivation needed to seek treatment or to seek help. It scares people,” Nash said.

A new bill proposed by the Honolulu City Council seeks to mandate the availability of Narcan in high-risk venues such as bars, nightclubs and other locations where alcohol and drugs may be present.

The move comes in response to the growing opioid crisis in Hawaiʻi, which saw 274 deaths from opioid overdoses in 2020.

“We need to use every tool at our disposal to help keep people safe. And, in high-risk environments where alcohol and drugs may be present, we want to make sure that just like having a first aid kit, just like having an AED. They have a tool like Narcan to help deal with overdoses.” Councilmember Dos Santos-Tam added.

Still, Methamphetamine remains the most dangerous drug in the islands; and it’s being mixed with fentanyl –a cocktail Narcan can’t help.

“Our emergency room physicians here in Hawaiʻi are battling with methamphetamine and fentanyl combinations or methamphetamine and cocaine combinations that fentanyl and methamphetamine cocaine tri combinations here,” Hawaiʻi High-Intensity Drug Trafficking Area Executive Director Gary Yabuta said.

He went on to further explain.

“So, you can treat the opium with our cans; but you really can’t do much for methamphetamine,” added Yabuta.

Even other opiates often have fentanyl.

“The drug supply that we have is not the same as maybe we had in the 90s or the early 2000s,” Nash said. “Now, pretty much all the opioid, all the heroin you buy is gonna be mixed with fentanyl; or it’s just straight fentanyl.”