Nashville health officials want more people carrying Narcan as overdoses spike, but how?

Public health officials are encouraging more Tennessee residents to carry the overdose reversal drug naloxone because of a sharp rise in drug deaths. But acquiring doses of the pricey Narcan nasal spray takes some maneuvering.

Andrea Hancock, a regional overdose prevention specialist funded by the state, spends most of her days training people to use Narcan and distributing two-dose kits — but only to those who need it most.

“Naloxone is one of those things you’d rather have it and not need it than need it and not have it,” Hancock says. “You never know when you’ll come across an opioid overdose.”

She says her own son’s life was spared by Narcan last year. He overdosed after using cocaine laced with fentanyl, which is increasingly common and helped lead to another record year of fatal overdoses in 2021.

The Tennessee Department of Mental Health and Substance Abuse Services has distributed 300,000 two-dose boxes since October 2017, with 44,000 confirmed lives saved, according to the agency. Especially with potent fentanyl, overdose reversal often requires two doses or more.

The spike in fentanyl-laced drugs has put more demands on the supply. The state uses mostly federal grant money to buy Narcan at $67.50 per unit. The vials of naloxone, which require the use of a syringe, cost just $3 a piece for the state and are not as widely used.

For those who are regularly around illicit drug use

Regional overdose prevention specialists, known as ROPS listed here, are the best points of contact. They will come and provide a brief training and — if needed — provide Narcan doses. On Thursday, the Main Library in Nashville is hosting a one-hour training at 11 a.m. and offering overdose kits “while supplies last.” Call (615) 862-5815 to register. STARS Nashville will offer more trainings at a community celebration June 11, 10 a.m. to 2 p.m., at 1704 Charlotte Ave.

Streetworks, which runs a needle exchange program, also distributes Narcan from both its mobile truck (contact here) and at its office at 1326B Rosa Parks Blvd in Nashville.

Low-income clinics, such as Neighborhood Health, will sometimes have Narcan available to hand out, though not always.

For those who just want to be prepared

There is a standing order at Tennessee pharmacies, which means Narcan is available without a prescription. But it’s likely not free. Private insurance can cover with a co-pay (I just ordered some generic Narcan while writing this paragraph from a Walmart pharmacy with a $10 co-pay, though the pharmacist said most insurance limits to one box per month). Starting in July, all opioid prescriptions should come with an offer of naloxone, under a new state law.

The cost out of pocket can run as high as $150. But Hancock recommends using GoodRx, which acts essentially like a coupon and brings the cost down to between $30 and $50.

“It can happen to the first-time users. It can happen to experimenters. It can happen to a toddler who accidentally gets into their caretaker’s medication,” Hancock says. “We’ve heard all kinds of stories, so we make sure the individuals have access to naloxone in order to save a life.”