previous legislation, signed by Gov. Snyder in 2014, which first allowed doctors to prescribe naloxone to medication-assisted treatment patients considered at risk of an overdose or to write a third-party prescription to the patient’s family member.
“The first law was to make naloxone available and decrease the risk to people acting as good Samaritans,” Morrone said. “Prior to that, naloxone was to be used only in emergencies.”
Morrone, a longtime naloxone advocate, was among doctors who testified before the Michigan House and Senate to have the original bill passed two years ago. Legislators asked about the potential for abuse of naloxone, whether it had dangerous side effects and if he had concerns about the prescribed medication being sold illegally. The answer to all of those questions, he said, was “no.”
“We have receptors in our brains that are kind of like a cup and ball,” Morrone said. “You can either fill that cup with opioids — like heroin or methadone — or naloxone. When naloxone is delivered, it essentially ejects all those other drugs.”
Naloxone, approved by the Food and Drug Administration, prevents opioid overdose by blocking receptor sites and reversing deadly overdose effects. Doses can be administered via nasal spray or injections, and the medication is often prescribed in a device that functions much like an EpiPen. It does not provide any sort of high, but may induce withdrawal symptoms — body aches, dizziness, fever, chills, nausea, etc. — in a patient upon injection, according to the Substance Abuse and Mental Health Services Administration.
Though increased availability of naloxone is recent in Michigan, the concept is not new. At least 39 states have passed legislation allowing naloxone to be dispensed or administered, according to the Network for Public Health Law, though many states still place restrictions on availability.
“In the state of Michigan, I have trained and handed out 100 naloxone kits to state police, 100 to sheriffs, 100 to local law enforcement and over 100 to the public,” Morrone said.
The next step toward availability, he hopes, will be a law to make the medication available over the counter.
“That was the big vision,” Morrone said. “Naloxone availability has to be put forward in a way that everybody could accept it, and the law was designed to go in three steps.”
But Morrone said the state push for that final step toward over-the-counter availability will be less aggressive now that patients will have two ways to get naloxone. The urgency for Michigan to have a standing order in place, he said, stemmed from uptake failure among doctors in the state following the first law.
“Physicians’ naloxone uptake was abysmal for a few reasons,” he said. “They don’t understand the addiction problem and don’t think it’s that bad; they didn’t want to admit that the power to change that could be given to people, and people didn’t want to admit that an addiction problem was happening right in their backyard.”