Stigma still stopping opioid users from seeking naloxone

A drug that can reverse the breathing suppression caused by an opioid overdose is now available at 135 Illinois pharmacies or drug education centers that have a standing order from the state to dispense it without a prescription.

So are suburban pharmacies seeing a rush on naloxone, also sold as Narcan and Evzio, as a precaution against accidental overdose deaths?

"No, not really," said Clark Kueltzo, pharmacist and co-owner of Lombard Pharmacy. "I would hope that we would."

What's stopping people, Kueltzo said, is not so much money - some forms of the drug are available for as little as $15 with insurance or $100 without it - it's perception.

Despite widely expanding use of naloxone by first responders during the past four years, Kueltzo said people are afraid to be seen picking up what's known only as an opioid overdose reversal drug. Buying naloxone means the customer either uses opioids for pain relief, misuses prescriptions to feed an addiction, or takes heroin or fentanyl to seek a high - or knows someone who does.

"There's always a stigma attached to getting those meds," Kueltzo said. "People don't want to be branded."

Independent pharmacies in Carol Steam and Geneva also say they haven't noticed an increase in customers buying naloxone.

That could change in some suburbs as doctors begin to prescribe naloxone more frequently, especially as a precaution when they prescribe opioids. Doctors at Edward-Elmhurst Health began following a new protocol Jan. 8 that requires prescribing a naloxone emergency kit when they give patients certain high doses of opioid pain medications.

Dr. Aaron Weiner, director of addiction services for Linden Oaks Behavioral Health in Naperville, said he hopes the new practice will help decrease the negative image of naloxone purchasers, increase awareness of the drug's purpose and potentially avert deaths.

Weiner said he understands why older opioid patients wouldn't want to talk about their long-term pill use and why younger opioid users want to keep their struggles secret. But he said keeping naloxone on hand should be seen as a smart move to reduce harm from a potential overdose, not as a shameful necessity.

"My belief is that stigma kills a lot of people," Weiner said. "We're hoping that this (co-prescribing) increases the dialogue."