Unless you’ve been shut off from the world for the last few years, you’ve probably heard of naloxone, the prescription medication that reverses the effects of an opioid overdose. It comes in both a nasal spray called Narcan and an auto-injector called Evzio, and it blocks the brain’s opioid receptors and restores normal breathing in people who have overdosed on fentanyl, heroin, or prescription painkillers. It’s been proved so effective that in April of 2018, the U.S. Surgeon General issued a national advisory encouraging more people to carry it. Unfortunately, there are still critics out there who are attempting to portray this life-saving medication as somehow doing further harm.
In March, economists from the Texas A&M University and the University of Wisconsin released a paper called The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime. They argued that greater access to the drug increases opioid use, opioid-related crime, and, in some places, deaths from overdoses. The study looked at the time periods before and after certain naloxone-related laws were put into place, such as providing legal immunity to people who prescribed or administered the drug or allowing anyone to buy naloxone in a pharmacy without a prescription. They found that as more laws go into effect allowing greater access to the drug, both arrests related to the possession and sale of opioids and opioid-related ER visits increased.
One of the authors referred to it as a moral hazard, saying that if you make something less dangerous, people are going to do more of it. In other words, knowing that they have that safety net there only encourages addicts to keep using.
Although the authors themselves don’t argue that we should restrict access to naloxone, many public health experts worry that it will harm the efforts to make the drug more widely available. The public response, perhaps unsurprisingly, was rather vitriolic. Critics took to Twitter to urge the authors to perform all manner of improbable acts on themselves, before devolving into incoherent cursing. One Twitter user called them monsters, while another asked “Are you Adolf Hitler?” The more rational among them pointed out that these claims were unfounded and only served to impede harm reduction.
It’s worth noting that the study, at the time of publication, was what is called a working paper, meaning it hadn’t been subjected to peer review. Critics say this makes it all the more irresponsible that they would release it and inflame the public. There are also plenty of other studies that have found the exact opposite. Finally, the authors seem to have failed to take into account certain facts that could change their conclusion, such as the fact that of course there are going to be an increase in emergency room visits when there is greater naloxone access, as the instructions for the medication clearly state to seek medical care after an overdose.
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