Thom Duddy, a spokesperson for the Narcan manufacturing company Adapt Pharma, is optimistic that new legislation being heard at the state house will help in the battle against the opioid overdose epidemic.

That legislation states that a prescriber must co-prescribe Naloxone when prescribing an opioid that is more than 90 morphine milligram equivalents (MMEs) per day, when prescribing any dose of opioid when a benzodiazepine has been prescribed in the previous 30 days, and when prescribing any dose of opioid to a patient with a prior history of opioid use disorder or overdose.

According to Duddy, there are roughly 500,000 opioid prescriptions written in Rhode Island per year, which is around 14 percent less than it was last year. He said Rhode Island has done “a good job” on that end, and the new legislation being proposed, which is already implemented in states like Vermont and Virginia, will also help.

“What we heard from physicians in Vermont and Virginia is that they’re having conversations with their patients, then looking at alternatives,” Duddy said. “They’ve changed high dose prescriptions to lower doses, maybe like 110 MME to 85 MME. They’ve also provided other physical therapy options.”

He said the “sheer number” of opioids that are out there is contributing the most to the problem, but the amount of Naloxone/Narcan kits available, which are opioid overdose combatants, should also be increased. He said that in Rhode Island opioids are being prescribed at 200 times the rate as any form of naloxone, and that number should be closer to 40-1.

“More than 50 percent of overdoses are happening in the home,” he said.

“Everyone thinks of injection as the illicit use of opioids. [But] 40 percent of overdoes come from legitimately prescribed opioids, although they may not have been taken legitimately.”

He added that pain physicians are accustomed to writing opioid prescriptions, including Vicodin and hydrocodone, but not used to writing naxolone prescriptions.

In high schools, he said, his company has started a program that places Narcan kits there because, as he said, high schools are “focal points of communities.” He said that people go to high schools not only for school, but for other reasons such as events or to vote, and these overdose kits should be available there. He also said that most Americans are aware that fentanyl and heroin are opoiods, however many don't realize that prescription medications like hydrocodone or Vicodin are opoiods and can cause an ordose if taken innapropriately.

The Narcan kits that Adapt Pharma create have two doses per box. The price to buy them is $125, but that is without any type of health care. He said that with Medicare or Medicaid that price is $5, and some insurance companies cover the whole cost. He also said that the kits can be used by anyone with a third grade literacy level, which emphasizes the ease with which they can be administered.

Another initiative they are taking is to get Narcan kits more into the hands of law enforcement, state officials and medical professionals, which the company gives to for free, though hospitals utilize more advanced naloxone methods, such as through intravenous drips (IVs).

Duddy said that the rate at which opioids are being prescribed – 9,900 scripts per week in Rhode Island – warrants a widespread effort to reduce this and help combat the opioid overdose epidemic.

A public hearing on the proposed legislation is scheduled for late June or July, and the final rules should be in effect sometime this year pending an approval vote.