A Wolf administration standing order allows anyone to pick up the opioid overdose reversal drug naloxone from a pharmacy without a prescription.
State officials expanded that order earlier this year to include four different forms of the drug, including a nasal spray and a syringe option with two injectable single-dose vials of naloxone. Speaking to 90.5 WESA’s The Confluence on Tuesday, Drug and Alcohol Programs Secretary Jen Smith said the state recognizes how the market for the life-saving drug is evolving.
“What we're trying to do is keep that standing order up to speed with all the different versions that are available so that people have access to a wide variety of types of naloxone,” Smith explained.
According to Smith, the highly-potent opioid fentanyl has become prevalent in cocaine and other stimulants across the commonwealth. More than 5,300 Pennsylvanians died from a drug overdose in 2021, including 719 people in Allegheny County.
The Department of Health confirmed 84% of fatalities were opioid-related. Of those, 47% involved a stimulant, such as cocaine or methamphetamine, up from 10% in 2020.
"So our messaging has shifted a little bit in this space to say even individuals who are typically stimulant users must have access to naloxone because we are hearing that there are overdose deaths related to individuals who are typically using methamphetamine or cocaine but actually overdosed as a result of the opioid contained in the substance," Smith said.
The standing order covers any resident who asks for naloxone at a pharmacy in the Commonwealth. Not all pharmacies, however, stock every form of the drug, and insurance coverage can vary by the type purchased and insurance plan. The state recommends people check with their insurance to determine whether naloxone is covered by their particular plan or requires an out-of-pocket cost.
In the case cost is a barrier, residents can get the overdose reversal drug by mail through the state’s free naloxone distribution program in partnership with NEXT Distro and Prevention Point Pittsburgh.
“You fill out your name and mailing address, and we will provide you a free dose of naloxone directly to your home,” Smith said. “So there's no reason that any Pennsylvanian should go without access to naloxone.”
To qualify, residents must also view a training video and answer a short quiz, available in both English and Spanish, on how to administer naloxone.
The Pennsylvania Commission on Crime and Delinquency also distributes naloxone for free to organizations and individuals. The commission’s Naloxone for First Responders Program has distributed more than 181,000 kits of Narcan, the brand name version of the medication’s nasal spray form, and over 265,300 kits to organizations serving high-need communities since 2017.
More than 22,815 overdose reversals have been reported using state-purchased Narcan.
Still, many harm reduction advocates say reducing fatal overdoses requires more than access to naloxone. Heeding that call, Gov. Tom Wolf signed a bill last month that decriminalizes fentanyl test strips.
It updated a law that classified the strips as drug paraphernalia and imposed significant penalties on those possessing them.
Smith, who is among those calling for additional measures, said she would like to see the legislature pass legislation that legalizes syringe service programs in the state.
The distribution of sterile syringes for drug use can incur a felony offense throughout most of Pennsylvania, even though the Biden administration provides funding to support such harm-reduction efforts.
In January, state Rep. Sara Innamorato, a Democrat from Allegheny County, and state Rep. Jim Struzzi, an Indiana County Republican, introduced legislation that would decriminalize the service. Currently, under the jurisdiction of municipal public health authorities, syringe services legally operate in Allegheny County and Philadelphia.
"Those are programs that have proven to improve health outcomes by reducing the spread of hepatitis C and HIV," Smith said, "so I would like to see that as our next step."
