The FDA is not required to follow the recommendations, but the expert panels are influential in crafting policy.
Naloxone, which can be injected or sprayed into the noses of overdose victims, has been available for decades and saved countless lives during the opioid epidemic. But it still is provided mostly by first responders and harm-
reduction groups that distribute it to illicit drug users, as well as by cities and states that have issued “standing orders” for prescriptions for anyone who wants to purchase it at a drugstore.
In April, U.S. Surgeon General Jerome M. Adams issued an unusual advisory urging American opioid users, their families and friends to keep naloxone nearby.
Martin Garcia-Bunuel, a committee member and official with the Veterans Affairs Maryland Health Care System in Baltimore, said he voted for the recommendation in hopes of prompting discussion between doctors and patients about keeping naloxone in the home alongside opioids.
“If done properly, it will help create a conversation, standardize a conversation that protects patients who aren’t getting this conversation,” he said.
But other committee members said it makes little sense to recommend a naloxone prescription for everyone who uses the painkillers, since most overdose deaths occur among illicit users of narcotics. Some suggested the recommendation be targeted at high-risk groups, such as people with respiratory problems or histories of abusing prescription narcotics. Others worried the guidance could lead to shortages of the antidote.
“Co-prescribing is the least-
effective method we talked about in terms of actually providing product to the patient,” said Raeford E. Brown Jr., a professor of anesthesiology at the University of Kentucky’s College of Medicine, who chaired the two-day meeting.