Kentucky pharmacists now are able to dispense a drug that can quickly reverse heroin and opioid overdoses without a doctor's prescription.
Under emergency state regulations filed last week, a pharmacist may dispense naloxone to a family member of an addict or to first responders such as police and firefighters without a prescription. Under the regulation, the pharmacist must have a naloxone protocol that is approved by a licensed Kentucky doctor. The pharmacist can set the guidelines on who may get naloxone — often known by its brand name of Narcan — without a prescription.
The emergency regulation was filed Thursday and took effect immediately, said Brian Wilkerson, a spokesman for House Speaker Greg Stumbo, D-Prestonsburg.
The regulation is part of much broader legislation passed this year to combat the state's rising number of heroin overdoses.
In 2014, there were 233 overdose deaths in Kentucky in which heroin was found in the bloodstream, up from 230 in 2013, according to a recent report from the state medical examiner's office.
"We're the first state in the nation to take this type of step, and I know it will make a true difference in reducing the steep increase of overdose deaths we have seen in recent years," said Sen. Whitney Westerfield, chairman of the Senate Judiciary Committee.
It's not clear how many pharmacists will participate in the program.
Mike Burleson, executive director of the Kentucky Board of Pharmacy, said the board moved quickly to write the regulations so pharmacists could participate.
"I think there are many pharmacists looking forward to participating in the program and doing all they can to save as many lives as possible," Burleson said.
Although the regulations took effect Thursday, pharmacists still must develop a protocol and have that protocol approved by a doctor. It's not clear how long that process will take and when the first Kentucky pharmacist will issue naloxone without a doctor's prescription.
The regulations say the pharmacist's protocol must be approved by a doctor at least once a year.
Kentucky's regulation comes as other states are trying to get naloxone into the hands of more people as the number of heroin and opiate addicts and overdoses continues to increase nationwide.
In 2013, nearly 2 million Americans abused or were dependent on opioids, and more than 16,000 died from the prescription variety, according to the Centers for Disease Control and Prevention. More than 8,000 other deaths involved heroin, to which many addicts migrate after becoming addicted to legal drugs.
New York, California, Illinois, New Mexico and Washington are among the states that have passed laws to provide legal protections for prescribers who work with programs providing naloxone to laypeople.
New York also is among states no longer requiring a patient-specific prescription for the drug.
Since making the change last year, New York state says it has trained 10,000 laypeople on the use of the drug, sending them home with a rescue kit containing Narcan and a nasal atomizer used to spray it in an overdose victim's nose. The state Health Department pays the $50 to $60 cost of the kits.
In addition to allowing pharmacists to dispense naloxone without a prescription, the Kentucky legislation allows for creation of a needle-exchange program in some cities — the Lexington-Fayette County Health Department said last week that it hopes to obtain local approval of a program by August — and a Good Samaritan provision that protects from prosecution people who report a drug overdose.
"All of this, on top of the much tougher penalties for traffickers, will have a major impact when it comes to reducing heroin use and overdose deaths," said Rep. John Tilley, chairman of the House Judiciary Committee.