Delaware AG pushes price cut for heroin antidote

Ten lives have been saved this year since a medication that is highly successful at reversing heroin overdoses was put in the pockets of officers in the Ocean View, Middletown and New Castle County police departments.

In one save, a county officer used naloxone to revive a 35-year-old Wilmington man found unconscious by his roommate. Paramedics in another situation in Ocean View used it to revive a 32-year-old woman twice in 10 hours.

But officials say the price of this life-saving medication could prevent more agencies from training and equipping officers.

In response, Attorney General Matt Denn is trying to strike a deal with the California manufacturer, Amphastar, to give government agencies and volunteer fire companies in Delaware rebates for the nasal form of naloxone, known by the brand name Narcan.

The sole manufacturer of Narcan raised the medication's price by about 50 percent last year – at a time when law enforcement nationwide was starting to buy it. After being blasted for the price hike, the manufacturer gave discounts to Ohio and New York agencies, and has publicly said it will consider requests from other states.

The medication works within minutes to reverse the effects of opiate overdoses and to restore breathing. Each kit, which could be used for two people, costs $110.

"If Narcan were less expensive, you'd see almost every agency in Delaware out there trying to give these folks an opportunity to get clean," New Castle County Police Chief Colonel Elmer Setting said.

Naloxone is only the first step in helping addicts and must be paired with adequate treatment – something many in Delaware say is lacking – but the medication is another way law enforcement is responding to an alarming number of overdoses, officials said.

Delaware Health and Social Services reported 185 suspected overdose deaths in Delaware in 2014. As of July, there have been 78 suspected drug overdose deaths in 2015.

The News Journal detailed in a yearlong series of the impact of heroin – from the parents whose children died from overdoses to the communities' plagued by crime. Naloxone was raised as one of many solutions.

Delaware's lawmakers last year approved legislation to make naloxone available without a prescription to those who complete training on its use. This opened the possibility for police, who often respond to an overdose minutes before paramedics arrive, to carry and administer it.

Three departments have since trained and equipped officers. Ocean View Police Department was first.

The town's council stocked the department's eight officers with Narcan for a cost of about $750. It has since switched to using a different form of the medication administered with a one-time, auto-injector, much like an EpiPen.

The injectors, which cost about $500 each, were given to the department by atTAcK Addiction, a group of New Castle County parents whose children died from opiate abuse or are in recovery from it.

"It isn't much to save a life," Ocean View Police Chief Ken McLaughlin said about the cost. "But there is no way an agency with limited resources could afford that."

The Middletown Police Department saw Ocean View's success and began using Narcan in its department in June. By early August, an officer had saved a 27-year-old woman found unresponsive and turning blue on her living room floor in the 100 block of East Lockwood Street.

"We had success within a month, which was outstanding," Middletown Police Captain Michael Iglio said. "Anytime you can save a life, that is a huge success, because we know enforcement alone doesn't work with these types of problems."

The New Castle County Police, the second largest law enforcement agency in the state, began a pilot program this spring where 38 police officers were trained to use Narcan.

The first of eight saves came just days after the officers were trained. An officer responded to a 911 call in the 500 block of Homestead Road in the Hidden Valley Apartments near Wilmington and found a 35-year-old man being given CPR by his roommates. Narcan helped restore the man's breathing.

New Castle County Police plan to continue rolling out Narcan to all officers as funding becomes available.

"If you have a small department the cost is relatively small, but for New Castle County Police to train every officer, it is a lot," said David Humes, a board member of AtTAcK Addiction.

Setting wants to go after federal grants recently announced under a new White House initiative to combat heroin. In the meantime, Denn is looking into funding for departments through the state's Special Law Enforcement Assistance Fund.

Denn hopes rebates from Amphastar could help other police agencies get Narcan. He wrote a letter to the manufacturer last month.

Amphastar did not respond to The News Journal's requests for comment, but Denn said the manufacturer "tentatively" agreed to negotiate.

"The issue now is how much the rebate will be," Denn said. Rebates for other states have ranged from $4 to $6 per dose, or about $16 to $24 per kit.

Humes has seen the price of Narcan rise, but still believes the government can find a way to fund it.

"Even in crunch time of a state budget, it is really not that much money," he said. "It seems as if there is an opportunity to save lives by getting all police on board."

But, Humes and others say Narcan is not the solution without adequate treatment opportunities.

"There is a broad consensus about the need to expand treatment," Denn said. "I don't think anyone believes we're at where we need to be."

For example, officers in Ocean View were called to the scene of an overdose around 10:30 p.m. a few weeks ago. Paramedics used Narcan to revive a 32-year-old woman addicted to painkillers and then transported her to Beebe Medical Center.

Hours later, McLaughlin and another officer were called back – to the same house. The woman had overdosed again and was lying on the bathroom floor.

Paramedics used the medication to save her for the second time. McLaughlin described her revival as a "miracle," but said treatment is a better way to address the addiction than repeatedly giving someone Narcan.

"You can't just keep doing that," he said.

Lawmakers allocated $4.45 million in the state budget this June for support programs aimed at expanding bed space and access to treatment centers.

Last week, officials announced that some of the money will go to a detox center in Harrington.

NET Kirkwood Detoxification in Wilmington is currently the only detox center in Delaware. The facility has 16 beds and can house patients for up to a week.

The new 15,000-square-foot center is slated to open at the end of September. It will have 16 inpatient beds for up to a week, 12 short-term stay beds, and about 30 to 100 intensive outpatient slots.

McLaughlin said the center is a good start, but will only begin to meet the need.

"It's 16 beds, when we need 16,000," he said. "But, it's a start, and it's better than nothing."

Contact Jessica Masulli Reyes at 302-324-2777, jmreyes@delawareonline.com or Twitter @JessicaMasulli.