TALLAHASSEE — The apparent drug overdose deaths of two young men on the campus of New College of Florida may highlight the need for a bill that Gov. Rick Scott will act on in the next few weeks that could prevent similar tragedies.
The bill (HB 751) — sponsored by Rep. Julio Gonzalez, R-Venice, and passed with near unanimous support in the Legislature — will create the Emergency Treatment and Recovery Act that will dramatically increase the availability of a medical antidote that can reverse drug overdoses if used quickly.
Examples of Naloxone, an overdose reversal drug. (WILMINGTON STAR-NEWS)
“This medication would be used only in the direst, life-saving circumstances,” Gonzalez, who is an orthopedic surgeon, told legislators. “These are real problems. These are real issues. These are lives that we are able to save from one day to the next just by enacting this bill.”
The bill would greatly expand the number of Floridians who could have access to opioid antidotes, like naloxone hydrochloride. Currently the antidotes are only available to medical professionals such as emergency room doctors and paramedics.
But the bill would increase that to include law enforcement officers and other first responders, such as emergency medical technicians. It would also allow Floridians struggling with drug addiction to obtain prescriptions for the antidote as well as their family members, friends or anyone “in a position to have recurring contact with a person at risk of experiencing an opioid overdose.”
“What we’re trying to do is increase the possibility that somebody’s life could be saved by having another person near that person have access to that medication,” Gonzalez said.
It comes at a time when Florida and many other states are seeing a surge in deaths from heroin and a synthetic opiate called fentanyl — drugs that Sarasota Medical Examiner Dr. Russell Vega said are the likely cause of the deaths of two young men within 48 hours earlier this month at New College.
Dr. Sharon Kelley, a drug expert and affiliate faculty member at the University of South Florida College of Medicine, called heroin and fentanyl the deadliest drug threats now facing Florida.
After Florida cracked down on illegal use of prescription drugs, including shutting down so-called pill mills, drug users moved to heroin, often laced with fentanyl, which can be 20 percent to 50 percent more powerful than heroin, Kelley said.
In Sarasota and Manatee counties, heroin and fentanyl overdoses killed 73 people last year — an increase that local substance abuse specialists call an “epidemic.”
If the measure becomes law, Gonzalez said it could put the opioid antidote into the hands of an estimated 30,000 to 40,000 law enforcement officers as well as up to 5,000 basic life support units.
“This absolutely will save lives,” Kelley said.
In addition to making the antidote more available, the bill provides civil and criminal immunity to those who prescribe the drug, dispense the drug or administer the life-saving injections if they are acting “in good faith.”
Gonzalez said he is not aware of any organized opposition to the bill and he does not expect opposition from Scott, once the governor receives the bill.
As of last November, 27 states had laws allowing for “third party” prescriptions of opioid antidotes, according to House analysts.
“Really what this bill does is it takes down a barrier that is keeping doctors from using a tool that we have in our toolbox and using our judgment to save lives,” said former Rep. Ronald “Doc” Renuart, R-Ponte Vedra Beach, who co-sponsored the legislation with Gonzalez.
But Kelley said the success of the bill will be determined by how it is used. Naxolone can be delivered as a nasal spray, making it easy to administer if the patient is still breathing.
The antidote drug revives patients and brings them back to a sober state. The drug user might feel well enough to resist going to the hospital or seeking treatment. But Kelley said that naxolone wears off after 45 to 60 minutes and the user can relapse into respiratory failure.
“Without proper treatment the resuscitated patient can have a second death,” said Kelley, who is the chief executive for the Associates in Emergency Medical Education and the Alliance for Global Narcotics Training. “It’s critical that we have the training and tracking to go along with the use of naxolone.”
Another concern, Kelley said, is that making naxolone readily available even to addicts themselves could make drug abusers even more reckless. She said a couple recently came into a local emergency room after one had overdosed.
“The man told the doctors, ‘Give her the heroin overdose drug like we have at home,’ ” she said. “You don’t want it to be seen as a safety net that encourages drug use.”
The legislation drew only one negative vote — from Rep. Michelle Rehwinkel Vasilinda, D-Tallahassee — as it made its way through a half-dozen House and Senate committees as well as the final votes on the Senate and House floors in late April.
But some members were initially uneasy with the legislation.
Rep. Katie Edwards, D-Plantation, who eventually backed the bill, said she wanted to make sure that if physicians were dispensing the antidote to drug addicts and others that they were also trying to make sure the patients were getting access to programs to help them with their addiction problems.
Edwards said she wanted to make sure Floridians with addiction struggles are “getting more than just something to have in the medicine cabinet in the event that they overdose.”
“I don’t want to encourage people to keep abusing thinking: ‘It’s OK. I can just have a syringe inserted and my overdose will stop.’ That’s my concern,” she said.
Other lawmakers had to be convinced that the antidotes, like naloxone that is sold under the brand name Narcan, would also not be abused.
“My understanding is this is not a drug that you would use to get high,” said Rep. Chris Sprowls, R-Palm Harbor, who has prosecuted drug cases as an assistant state attorney. “Quite frankly, it does the entire opposite. It counteracts those drugs to save lives.”
“I think what you’re doing here is important, giving first responders and family members a tool to use to save their loved ones,” Sprowls told Gonzalez and Renuart in a hearing before the House Health and Human Services Committee.
Renuart, an osteopathic physician who has experience as a first responder, said when emergency workers reach an unconscious individual they usually administer a sugar solution and Narcan, not knowing whether the coma is the result of diabetes or drugs.
“Either one of those medications would take them right out of it and save their lives,” Renuart said.
Renuart also dismissed the concern that the law would be helping people involved in the illegal use of drugs. He likened it to watching a drunken driver crashing into a ditch.
“You’ve got the ability to save them. Would you not save them because you know that it was their fault for driving into the ditch? No, you would do what you could. We all would.”
A RISING SCOURGE
As Florida has moved to shut down pill mills, drug abusers have shifted from prescription drugs to heroin and even more powerful opioids such as fentanyl. A new report by the Florida Medical Examiners Commission found:
121 fewer deaths from prescription drugs between January and June of 2014 compared to the same period a year earlier.
Deaths caused by heroin rose 102.9 percent compared to a year earlier.
Deaths caused by fentanyl increased 67.5 percent.
Source: 2014 Medical Examiners Commission Interim Drug Report
