| More than 100,000 Americans died of drug overdoses in 2021, according to the latest data from the Centers for Disease Control and Prevention. While drug-overdose deaths have been a growing issue in the US for some time, it has accelerated alarmingly in recent years, more than doubling between 2015 and 2021.
And while the data suggests the pandemic had a role to play in that surge, another statistic speaks to a new dimension to the problem: the surge in illicit fentanyl. Around 70,000 deaths in 2021 were due to fentanyl-related drug overdoses.
This fentanyl-fueled crisis has forced lawmakers to take action, including by expanding access to opioid overdose reversal drugs. This year US regulators have made two opioid reversal drugs available without a prescription. Until recently, the medication was only available through medical professionals at pharmacies or health centers, which created a barrier to access the treatment. This approval allows the medication to be bought at retail drugstores, convenience stores, gas stations and online. In March, Narcan nasal spray became the first opioid antidote approved for over-the-counter use. The drugmaker, Emergent BioSolutions, said it would likely cost less than $50 per carton of two doses. At the time, the Food and Drug Administration commissioner Robert Califf said the approval of an over-the-counter naloxone product addressed "the dire public health need."
And, just last week, the US Food and Drug Administration approved another naloxone-based spray called RiVive for nonprescription use. The drugmaker, Harm Reduction Therapeutics, expects the medication to be on shelves by early next year. The nonprofit company also pledged to make 200,000 doses available free of charge. These nasal sprays must be affordable because most health insurers do not cover over-the-counter medication. Of the two million non-elderly adults with opioid use disorders, nearly 1 in 5 have no medical insurance, according to 2019 KFF research. The study also found that those without health coverage are less likely to get treatments. While it's too early to see how making the medications available over the counter will reduce opioid overdose deaths, there are some promising examples outside of the US of the positive impact of widening access to the drug. In one UK county, for example, a small group of police officers have been trained in how to administer naloxone spray and now carry it with them. Carrying the nasal spray has helped officers save six lives so far, according to a Hertfordshire Constabulary press release last week. — Fiona Rutherford | 
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