October 20, 2018
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Why pharmacists still can’t give out Narcan without a prescription

Hampden Police Department | BDN
Hampden Police Department | BDN
Hampden police used Narcan to revive an unresponsive man Wednesday.

AUGUSTA, Maine — A law that allows pharmacists to dispense medicine that reverses an opiate overdose without a prescription has been stalled for more than a year due to a language technicality — but may soon be amended to fix the problem, officials said.

The Legislature last April passed LD 1547 to make naloxone, often sold as Narcan nasal spray, available at pharmacies without a prescription, so opiate users and their family and friends could have easy access to the life-saving medication.

But in an apparent mistake, the bill introduced by Rep. Sara Gideon, D-Freeport, still requires would-be users to have a prescription. The bill’s language calls for the establishment of procedures and standards for dispensing naloxone — something pharmacists already do — but it doesn’t say they can give out the medicine without a prescription.

“There was a problem with the law that did not become known until after closure,” Rep. Karen Vachon, R-Scarborough, said about why she submitted an after-deadline bill this week that a legislative panel on Wednesday approved to move forward.

It amends Gideon’s bill by adding the words “may furnish,” among other minor training changes for pharmacists, Vachon said. Gideon did not return messages left for comment about the wording of the bill, but the messages were apparently sent to Vachon.

The measure is part of an effort to address the state’s drug epidemic. An opiate was involved in 303 of the 376 overdose deaths in Maine in 2016, a number that has grown from only 60 in 2000.

The Maine Board of Pharmacy was tasked with writing the rules for LD 1547. During the process, board members tried to modify the law to align with Gideon’s intent, LePage wrote in a Jan. 18 letter to the representative, who is now the speaker of the House.

“A rule cannot change a law,” said the governor, who has repeatedly voiced opposition to the use of Narcan, which can immediately reverse the effects of an opioid overdose.

[MORE: LePage wants Mainers repeatedly revived by Narcan to pay for it]

“I am not certain what the legislative intent behind your bill was but I believe it was simply poorly drafted,” LePage wrote. “If you wish to allow naloxone to be obtained over the counter — a policy I believe to be unwise and counterproductive for reasons I noted in my veto message accompanying your bill — then you must introduce a new bill and see it enacted in order to achieve your desired result.”

The wording on Vachon’s bill will be posted around May 11, and more than likely will be assigned to the Legislature’s Health and Human Services Committee, according to Clarke Reiner, a legislative aide for Vachon.

Gideon proposed her naloxone bill after U.S. Sen. Angus King wrote to CVS Health urging the company to provide the medicine over-the-counter at its 22 stores in Maine as it already does in 15 other states, including Rhode Island and Massachusetts.

The company then reached out to Gideon about sponsoring the legislation to allow pharmacists to dispense the medication without a doctor’s prescription, and are now helping Vachon.

Heroin users, those prescribed high doses of opiates for medical reasons, or who are taking an opioid in combination with another drug, and those who are enrolled in medication-assisted treatment to fight addiction should have access to naloxone, said Dr. Noah Nesin, Penobscot County Health Care vice president of medical affairs.

“As a public health measure, the broader the available of naloxone in the community, the more lives will be saved,” Nesin said.

 


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