Putting naloxone within reach

It's hard to find pills in Eric Bedingfield's house.

"If you can find a medicine bottle, good for you — Because you have performed a miracle," said Bedingfield, who retired from the S.C. House in January.

"My kids cannot walk in my bathroom and open a medicine cabinet and see bottles." All medications "are on lockdown in my house," he added.

Bedingfield, a diabetic, said he'd never thought twice about taking his medication in view of his children. But he feels differently now.

This winter, he addressed the Association of SC Mayors about opioid abuse, a problem that kills 91 people nationwide each day. It's an acutely personal crusade for the Greenville Republican, who chaired the House Opioid Abuse Prevention Study Committee. He lost an adult son in 2016 to an overdose.

In January, Bedingfield's committee released a report that makes a host of recommendations to the S.C. General Assembly for how to halt the rising human and economic toll of addiction.

Among them is a recommendation of ways to increase access to naloxone (sometimes sold under the brand name Narcan), a drug that can reverse an opioid overdose if administered in time. Currently, an individual may buy a dose of the medicine over the counter for $120 at a retail pharmacy without a prescription, provided there is a standing order, a collaborative agreement between a doctor and a pharmacy that permits the dispensation.

There has been some progress in the General Assembly.

The South Carolina Overdose Prevention Act, enacted in 2015, granted civil and criminal immunity to doctors, pharmacists, caregivers and first responders who were involved in prescribing, dispensing and administering naloxone in a suspected opioid overdose. Shortly after the new law was enacted, law enforcement and health officials created the Law Enforcement Officer Narcan program to provide training on the identification, treatment and reporting of opioid overdoses.

But some lawmakers believe South Carolina can do more.

"A lot of times, access and care is more difficult than most people would think," said Bedingfield.

"When a person is ready to go get treated, they need treatment then," he added. "If they can't get it then or within the next 24 hours, they're probably going to use again."

When someone expresses a willingness to receive treatment, Bedingfield also urges the individual's friends and family members to be prepared. He suggests they purchase naloxone from a pharmacy and keep the medicine and the vulnerable individual close at hand.

Bedingfield said he would like community groups, such as the Salvation Army, to be able to purchase naloxone directly from manufacturers for $35 – $40 per dose, so that those organizations can also assist people in need.

He urged against stigmatizing opioid addicts. They're not lost causes — They're a brother who is recovering from surgery, a grandmother who's taking pain medicine under hospice care or a grandchild who takes the grandmother's medicine.

"It can take your child as quick as it took mine," said the former lawmaker.

Highlights of the opioids report

In January, the S.C. House of Representatives Opioid Abuse Prevention Study Committee released a host of recommendations, including some that would have particular relevance to local governments.

Empower "community distributors" of overdose antidotes.
Often, addiction sufferers can't or won't purchase naloxone from a pharmacist. So, lawmakers should pass legislation that allows a "community distributor" to provide opioid overdose antidotes. Community distributors would be considered any public or private organization that offers substance-use disorder assistance and services, such as counseling, homeless services, advocacy, harm reduction, treatment, and alcohol and drug screening to individuals at risk of an opioid-related overdose.

Expand prescription drug take-back day events and drop-off box locations.
Local governments and public and private entities should partner with law enforcement agencies to create community events associated with national and community-sponsored prescription drug take-back days. These partnerships should also increase the availability of prescription drug drop-off boxes by coordinating with local law enforcement agencies.

Coordinate with the U.S. Drug Enforcement Agency for timely removal of prescription drugs collected from law enforcement agencies.
State and local law enforcement agencies should coordinate with the DEA to develop policies to dispose of these medications in order to lessen the burden on local law enforcement departments, which accumulate large quantities of prescription opioids. Certain federal regulations limit disposal options, and law enforcement entities must often retain and store prescription drugs indefinitely.

Support workforce initiatives to increase awareness and access to treatment.
The state should establish comprehensive drug-free workplace policies for employees and implement training for human resources personnel on how to recognize the signs of opioid use disorder and to refer sufferers to treatment.

Evaluate the geographical availability of facilities and the potential expansion of detoxification programs.
State substance abuse officials should review withdrawal management programs, initiate policies about the need for in-patient or out-patient detoxification treatment programs, and establish detoxification facilities based on needs of each community. This review should identify geographic areas that need additional facilities, capital improvements, or expanded detoxification programs, including transitional housing and rehabilitation programs.