The state has given tens of thousands of doses of a drug that can reverse opioid deaths to local governments. It can still save lives after its expiration date, but some government agencies are destroying older doses.
In 2019, the state of Texas gave out more than 230,000 doses of naloxone, a life saving medicine that can reverse opioid overdoses, through its More Narcan Please program. More than three years later, that medication, in the form of a nasal spray known as Narcan, is past the expiration date printed on its label.
Medications are tightly regulated in the U.S., and for good reason, said Joy Alonzo, a clinical associate professor in the Department of Pharmacy Practice at the Texas A&M Irma Lerma Rangel School of Pharmacy and co-chair of the Texas A&M University School of Public Health’s opioid task force. It’s difficult for the government to get involved in a program that would encourage people to collect and distribute medication that regulators say is expired.
In 2019, as part of a response to increasing reported opioid overdoses in Texas, the state launched More Narcan Please, using federal grant money to purchase the lifesaving drug then distributing it free of cost. The University of Texas Health Science Center at San Antonio was chosen to administer the distribution. Individuals can request a box containing two doses. Organizations that distribute naloxone can make bulk orders.
“At this time, the More Narcan Please program does not participate in organized re-distribution of expired naloxone,” said Lisa Cleveland, a professor of nursing at UT Health San Antonio who oversees the state’s overdose prevention education program as well as the More Narcan Please program. “On occasion, and in cases of dire need, our program has facilitated communications between community partners wishing to redistribute expired, yet still usable naloxone, to other organizations in need.
“What I assume through previous observations, when a law enforcement agency requests naloxone, it’s going to give one to every officer, one to every patrol car, along those lines,” Hill said. “If they happen to encounter an overdose, they use it. If not, it expires. At that point it can be contributed to a harm reduction agency.”
In 2020, the FDA extended Narcan’s shelf life, changing the expiration date on the label from two years after manufacturing to three years. Between 2020 and 2022, More Narcan Please distributed more than 300,000 additional doses, according to the data obtained by Texas Community Health News. The program had $5.59 million in fiscal year 2023, enough to purchase more than 175,000 doses, according to the Health and Human Services Commission.
By last year, hundreds of those unused doses were expiring, said Lucio, the county’s substance use disorder program coordinator. Lucio sits on the board of several organizations dedicated to combating the opioid crisis, and has gotten to know people working at nonprofits that provide services to people who use drugs. It was clear they needed more doses, and she had a way of providing them.
But not all. The Texas Municipal Police Association received 4,800 doses between 2019 and 2022 that it distributed to law enforcement officers who attended trainings about the opioid crisis. Tyler Owen, the organization’s social media and communication manager, said he’s not aware of any efforts to get those departments to donate expired doses.
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