Virginia Issues Standing Order for Naloxone
Dr. Marissa Levine, The Virginia State Health Commissioner, has issued a standing order for Naloxone, the drug used to treat emergency opioid overdoses. Naloxone, often administered as a nasal spray (Narcan), is an opioid antagonist that quickly and effectively counteracts the effects of drugs like heroin, fentanyl, oxycodone, Vicodin, and carfentanil[2,3]. This new order allows patients or family members to purchase Naloxone without a prescription, where previously one was required.
In a statement delivered on November 21, 2016, Dr. Levine, noted that each day, over 24 Virginians are treated and 3 die from drug overdoses. This opioid crisis is especially severe in southwestern Virginia, where there is a “growing prevalence of hepatitis C and HIV resulting from injection drug use”. As a result, Dr. Levine declared a Virginia Public Health Emergency for the opioid epidemic.
This standing order comes amidst a new, potent opioid–carfentanil–that has been increasingly seen throughout the United States[6,7]. The DEA estimates this drug to be 500,000 times more powerful than heroin. Rather worryingly however, carfentanil may be too potent for Naloxone to have an effect.
Several pharmacies throughout Virginia, including CVS, Walgreens, and Kroger, have begun to offer naloxone without a prescription. According to a local pharmacist in Charlottesville, VA, it’s possible to walk into a pharmacy today with about $80 and walk out with a dose of Narcan without a prescription.
 “State Health Commissioner Comments on Opioid Addiction Declaration – Virginia Department of Health,” accessed April 14, 2017, http://www.vdh.virginia.gov/blog/2017/04/03/state-health-commissioner-comments-on-opioid-addiction-declaration/.
 National Institute on Drug Abuse, “Naloxone,” September 26, 2016, https://www.drugabuse.gov/related-topics/naloxone.
 National Institute on Drug Abuse, “Opioids,” May 27, 2016, https://www.drugabuse.gov/drugs-abuse/opioids.
 “State Health Commissioner Comments on Opioid Addiction Declaration – Virginia Department of Health.”
 “DEA Issues Carfentanil Warning to Police and Public,” accessed April 14, 2017, https://www.dea.gov/divisions/hq/2016/hq092216.shtml.
“CARFENTANIL: A NEW CHALLENGE IN THE OPIOID EPIDEMIC,” GROUNDS, accessed April 14, 2017, http://www.vabioethics.com/content/2016/10/20/carfentanil-a-new-challenge-in-the-opioid-epidemic.
 Associated Press, “Virginia Krogers to Offer Naloxone without Prescription,” WAVY-TV, January 31, 2017, http://wavy.com/2017/01/31/virginia-krogers-to-offer-naloxone-without-prescription/.