Opinion column (op-ed) by Don R. Read, MD, president of the Texas Medical Association (TMA), on improving distribution of naloxone in Texas to potentially save the lives of people who overdose on drugs.

It is now one year since Texas doctors have been able to get the lifesaving drug naloxone to people who can use it to help themselves and others avoid the effects of a drug overdose. Giving people access to a drug addiction treatment that can save someone else’s life is a huge opportunity to prevent overdoses. However, are we doing enough to get this drug to the people who need it?

Naloxone prevents a drug overdose by blocking another drug’s bad effects. The 2015 Texas Legislature permitted doctors to write standing orders, or prescriptions, for naloxone. The law allows any pharmacy that has a standing order to dispense naloxone to anyone who asks for it, to keep on hand as a precaution.

This can help people in danger of overdosing — and people who could save others from overdosing, like people who work with the public, or those with friends or family members who use potentially dangerous drugs.

Drug addiction and overdose are serious problems in Texas, and a top cause of accidental injury and death among adults. Overdoses from prescription opioids (painkillers) such as fentanyl, hydrocodone, and oxycodone, or illegal opiates such as heroin, affect Texans of every class, ethnicity, sex, and age.

Not everyone who overdoses is addicted to drugs. Sometimes people who take prescription pain medication accidentally take too much. Naloxone could help anyone in an emergency. Naloxone can prevent death if the victim takes it in time to stop the imminent threat, and then receive more extensive, necessary emergency care.

Nevertheless, true drug addiction is a complex disease, and our response for our patients should be as well. Here is what we need in Texas to accomplish this:

  • We must get naloxone to more people who need it — in their own community.
  • We must raise public awareness about overdosing — especially from prescription drugs, but also from alcohol, it is important to get an alcohol detox before it is too late. We need community training to handle overdoses so emergency responders and others can recognize overdose symptoms and give the victim naloxone.
  • We must get more people into effective Drug and Alcohol Treatment. Recovery from drug and alcohol addiction takes a long time, and a person may need more than one approach to succeed.
  • We physicians must be fully informed about prescribing opioids and naloxone. Doctors who prescribe painkillers must talk to patients about drug risks, learn the best ways to treat pain safely, and prescribe naloxone.
  • We must keep better track of prescriptions for opioids. Physicians and others can make better use of our state’s prescription database of controlled drugs like opioids to make sure patients aren’t “doctor shopping” for them.
  • We must improve information-gathering. Not all prescription drug deaths are counted because Texas does not have a standard way to report them. Better reporting would help us understand what is happening in our state.

Physicians applaud and support everyone working to solve our state’s opioid overdose problem, like groups that raise awareness about opioids and drug addiction, and lawmakers and regulators seeking to shut down unethical pain clinics, or “pill mills.”

We also urge others to be leaders in this effort. We need a statewide dialogue on working together to find solutions. We need community partners willing to make sure naloxone is available to treatment programs and emergency medical services. Texas must fund treatment based on scientific evidence. State leaders, and state and local health departments can be important partners in saving lives.

Texas is not alone in passing laws to make naloxone more available to people; all but three states have such laws. We can follow other states’ methods for cutting overdoses and getting naloxone to those who need it: pilot programs to distribute the drug; local or statewide opioid prevention plans; Good Samaritan protections for anyone who witnesses an overdose and calls 911; and public awareness campaigns.

The health — and lives — of many Texans is at stake.

Don R. Read, MD
President, Texas Medical Association