NEW ORLEANS -- In April 2018, U.S. Surgeon General Jerome Adams encouraged more Americans to carry naloxone, a lifesaving drug that can temporarily reverse opioid overdoses.
"Knowing how to use naloxone and keeping it within reach can save a life," he wrote in an advisory.
Understanding that access to the drug is key to reducing opioid deaths, Baton Rouge-born pharmacist James Lott, who now lives in Chicago, founded a business that aims to get naloxone in the hands of as many people as possible.
Louisiana last week became one of 35 states allowing online orders for naloxone on the website NaloxoneExchange.com, run by the company Script Health.
A customer types in their information and watches a short instructional video. Two or three days later, the package arrives at their door, said Lott.
The website doesn't take insurance, so the treatment is expensive: $99 for two doses of medication and two nasal atomizers, or $158 for two doses of Narcan, the brand-name version of naloxone that comes in an easy-to-administer spray bottle.
A handful of syringe-exchange services in Louisiana offer naloxone overdose kits for free, and pharmacies like CVS and Walgreens offer it in Louisiana without a prescription. Insurance typically covers the cost when a prescription is written.
But Lott said there may be reasons why a person wouldn't want to simply walk up to the pharmacy counter and ask for naloxone.
"If you grew up in the same town and you all went to high school and middle school together, going into the pharmacy to get naloxone is very challenging," he said.
In small towns without major brand pharmacies, the pharmacist may not carry naloxone. And some employees might not know it doesn't require a prescription, something Lott came across in Chicago in December.
"The pharmacy technician didn't know what it was," said Lott. "I had to argue with them." The employee said a prescription was required -- until Lott told them he was a pharmacist himself and showed them the law.
Overdoses from opioids claimed the lives of over 1,000 Louisiana residents between 2015 and 2017, according to a report by the Bipartisan Policy Center. Over those three years, the rate of overdose deaths from opioids rose by almost 50%.
Naloxone could help reverse those numbers; early data show opioid deaths plateaued in 2018.
"If they have the instructions, then getting it in the hands of as many people as possible is a great idea," said Rhonda Irving, the CEO of the Capitol Area Reentry Program in Baton Rouge. "I've had parents call me to get clean syringes for their kids," she said, but sometimes they don't want to come into the building.
The people using the service so far are typically relatives of people abusing opioids, said Lott. "Loved ones, moms, brothers, sisters. They don't want them to relapse. If they're actively using, they don't want them to die. We'll have someone order from Florida and ship it to their loved one in Texas," he said.
The state Health Department is also making moves to reduce opioid deaths after partnering with the PEW Charitable Trusts' substance use prevention and treatment initiative.
Methadone, a treatment for opioid addiction, is now covered under Medicaid. And Gov. John Bel Edwards recently signed a slew of resolutions for addiction treatment: Medication-assisted treatment will be available at more facilities, and Medicaid will also cover helping patients transition from the emergency room to providers with addiction services.