July 06—A month after the California Department of Public Health issued a statewide standing order for naloxone, the emergency antidote for opioid overdoses, the agency has authorized 27 organizations across the state—mostly pharmacies and addiction treatment centers—to distribute and administer the medication without a prescription.
The order was issued by agency director Dr. Karen Smith on June 8. Previously, organizations needed a prescription from an individual physician in order to distribute naloxone. Smith's order functions as a standing prescription for organizations that have a hard time finding such a doctor—a problem in small and rural communities where physician shortages are common, and addiction medicine is outside the purview of many doctors' practices.
"It's one step in our multifaceted approach to increasing ready access to naloxone," Smith said in an interview last month about the order.
Among those newly authorized to distribute and administer naloxone are 11 pharmacies, including Kmart locations in Tehachapi (Kern County), Grass Valley (Nevada County) and Freedom (Santa Cruz County); seven substance use disorder treatment centers in Sacramento, Costa Mesa and elsewhere; three law enforcement agencies; two syringe exchange programs; and one school district, Pasadena Unified, according to the California Department of Public Health. The organizations are located throughout the state, from Lake, Plumas and Sacramento counties in Northern California to Los Angeles, Orange and San Diego counties, as well as pockets of Central California.
"Entities in more rural areas may be applying for a statewide standing order for naloxone because these are the areas experiencing the highest rates of opioid overdose deaths," said a spokeswoman for the Department of Public Health. "The standing order is filling an identified gap for those that have naloxone, but no standing order in place to distribute or administer the naloxone."
To get authorization from the state health agency, the organizations had to apply and undergo training on how to recognize an opioid overdose and administer naloxone. Naloxone, commonly sold under the brand name Narcan, is administered by nasal mist and temporarily reverses the effects of an opioid overdose by knocking opioids off of receptors in the brain that suppress breathing, thus restoring respiratory function.
In the Bay Area, naloxone is generally more accessible than in other parts of the state because many harm-reduction organizations and addiction treatment centers have long operated under a standing prescription for naloxone from a local physician.
State officials have taken several steps in recent years to make the medicine more available. In 2015, state regulations took effect that allowed California pharmacists to make naloxone available without a prescription, but not all pharmacies carry it. Police officers and paramedics are also being trained to administer the drug.