Start-up fights to spread naloxone use for opioid overdose

By Xiaoyi Liu
Medill Reports

Click on the button of “Get Naloxone” on the webpage and you can purchase naloxone, a medication designed to rapidly reverse opioid overdose and get it delivered to your doorstep. This is the service that Naloxone Exchange will provide at its launch next year.

Naloxone Exchange is the signature product of Fiduscript, a company formalized in 2017 by James Lott, a graduate student at the University of Chicago Harris School of Public Policy.

As a pharmacist at the time, Lott dealt with many cases of substance use disorders. “Remembering those instances, having people bringing in fraudulent prescriptions, all those things – they kind of got me to this place where I can use everything I’ve learned and bring a solution to people that’s sustainable and that can save their life.”

More than 72,000 Americans died from drug overdoses in 2017, showing a two-fold increase in a single decade, according to the Centers for Disease Control and Prevention.

Naloxone can quickly restore normal breathing and save the life of a person who is overdosing on opioids. It is a safe medication that is widely used by emergency medical personnel and other first responders to prevent opioid overdose deaths, noted by National Institutes on Drug Abuse. However, as a result of the insufficient naloxone distribution, by the time a person on an overdose is reached, it is often too late.

“Knowing how to use naloxone and keeping it within reach can save a life,” states Dr. and Vice Admiral Jerome Adams, the Surgeon General of the United States, on the government naloxone advosory website. The American Medical Association also calls for an increase access to naloxone so as to help save lives.

Inspired by what he learned from class that an initiative could have a higher possibility of success when it had already gotten support, Lott realized that naloxone might be the key to addressing the opioid epidemic.

Naloxone Exchange partners with pharmacies that are qualified for standing orders, they are legal authorizations from a physician that can be carried out by other health care workers when predetermined conditions have been met. Presently Illinois and Texas have approved that Naloxone Exchange can launch in their state, and approval from more states are pending.

“One thing we know is that stigma is a big barrier to accessing treatment and services,” said Lott.

The Fiduscript team did a 528-people survey and it turned out that the majority of the patients with substance use disorder do not feel comfortable talking to a doctor or pharmacist about their substance use, and many of them, if given option, would prefer to get this medication online.

Lott hopes that Fiduscript could bypass the stigma and fill coverage gaps through enabling people to order naloxone online in places where there are no hospitals or pharmacies.

“It’s a preventive strategy to prevent people from dying through overdose,” said Nick Szubiak, integration consultant with the National Council and the former Assistant Vice-President of Addiction and Recovery at the National Council for Behavioral Health. “Those biases result in discriminatory policies and practices that create road-blocks in helping people with substance use disorders access the care, and in this case getting life-saving medication in the community helps protect people.”

Nick Szubiak sharing his opinions on the addiction epidemic at Medill Health Care Reporting Conference.
Nick Szubiak sharing his opinions on the addiction epidemic at Medill Health Care Reporting Conference.  (Abigail Foerstner/Medill)

Lott is heading to the Clinton Global Initiative University meeting which will be held by the University of Chicago later this month and present his start-up company as a 2018 delegate.

“Fiduscript has great potential to bring life-saving solutions to more families and other caring community members that want to take action,” said E.J. Reedy, senior director of the University of  Chicago’s Polsky Exchange program, who coached Lott this summer. He said he was really excited to see Fiduscript get to market and to expand the availability of naloxone and some of the other services that they are tempting to provide.

“Our goal is to leverage technology and create sustainable solutions for people who really are serious about getting treatment,” said Lott.

“The current model may not work for everybody, but with our model, I think it’s robust enough to work for a lot more people and give them more options of how they want to receive treatment.”

Photo at top: A volunteer practices the procedure for injecting naloxone at the Chicago Recovery Alliance. (Jessica Nieberg/Medill)
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