Staff Columnist

Legal uncertainty surrounds overdose-fighting drug

Naloxone is legal to obtain in Iowa, despite some confusion

The Iowa Harm Reduction Coalition gives out free Naloxone kits during a mobile outreach event in downtown Cedar Rapids on Monday, April 23, 2018. The kits include directions on use of  the medication to reverse an opioid overdose. (Cliff Jette/The Gazette)
The Iowa Harm Reduction Coalition gives out free Naloxone kits during a mobile outreach event in downtown Cedar Rapids on Monday, April 23, 2018. The kits include directions on use of the medication to reverse an opioid overdose. (Cliff Jette/The Gazette)

You may have the power to help fight the opioid epidemic in Iowa.

Naloxone is a powerful treatment able to reverse opioid overdoses, and it’s now available without a prescription at dozens of pharmacies across Iowa. However, evolving rules and regulations have left many Iowans, including some law enforcement officials, unclear about its legality.

This is literally a life-or-death issue here in Iowa, where the number of opioid-related deaths tripled between 2005 and 2016. State experts estimate there were about 100 opioid overdose deaths last year. And health officials warn we have not yet seen the worst of the opioid epidemic.

“The situation has not peaked yet. It’s still coming,” Linn County Public Health Director Pramod Dwivedi said last month during a public forum on opioid abuse.

Also known by brand names Narcan and Evzio, naloxone is an opioid antagonist, meaning it combats the effects of opioid drugs, like heroin and prescription painkillers. Applied through injection or a nasal spray, naloxone works within minutes.

In 2016, the Iowa Legislature passed a law to expand access to opioid antagonists. The bill was approved almost unanimously by Iowa lawmakers and signed by former Gov. Terry Branstad. It had widespread support from medical professionals and emergency responders, and even from police groups which have been skeptical of other harm reduction strategies.

That legislation cleared the way for the Iowa Department of Public Health and Iowa Board of Pharmacy to develop a statewide standing order, authorizing many more Iowans to get naloxone. Under the rule, first responders, anyone at risk of an opioid overdose, their friends and family, or any person in a position to assist an at-risk person can obtain and carry naloxone products.

Instead of a prescription, buyers only need to undergo a short assessment with a qualified pharmacist. Now naloxone products are widely available, even at the University of Iowa, Hy-Vee, Walgreens and CVS.

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However, even as everyone in the law enforcement and public health communities agrees opioid abuse represents a deadly crisis in Iowa, some harm reduction advocates complain police have continued to confiscate naloxone from subjects, even since the standing order was signed last year.

In at least one case in May, Cedar Rapids police charged a man with unlawful possession of a prescription medication because they found naloxone, along with other charges related to an assault.

Police have since dropped the prescription medication charge. Additionally, Cedar Rapids Police spokesman Greg Buelow told me officers have been instructed not to submit charges over naloxone in the future.

Representatives from the Iowa City Police Department and the Johnson County Sheriff’s Office told me they aren’t aware of any charges filed over naloxone possession, but neither department has set protocol for when officers encounter subjects with the medication.

Harm reduction advocates who distribute naloxone to at-risk individuals say they are pleased with the progress they’re making in educating law enforcement.

“By refraining from confiscating naloxone, or arresting and charging individuals with possession of it, law enforcement is taking a positive step toward beginning to build trust with one of the most a vulnerable and underserved groups in our community,” said Sarah Ziegenhorn, executive director of the Iowa Harm Reduction Coalition.

Naloxone is one of the single most powerful tools we have for fending off opioid overdose deaths — but only if we can get it into the hands of the people who need it.

“Everybody should have access to it. … Our job is really to make sure everyone who needs to have naloxone, can [get it].” Dwivedi said.

• Comments: (319) 339-3156; adam.sullivan@thegazette.com

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