Naloxone nasal spray too pricey for those who need it, frontline workers say

Health Canada has approved a nasal-spray form of the potentially life-saving drug naloxone, but at $145 for two single-use doses, people on the front lines of harm reduction say those who need it, can't afford it. They want Quebec's health minister to act.

Harm-reduction agencies call on Quebec's health minister to cover cost of potentially life-saving drug

The nasal spray version of naloxone was developed by Adapt Pharma, a Dublin-based company that markets the product under the brand name Narcan. (Adapt Pharma)

Some front line overdose prevention workers in Montreal say a nasal spray version of the potentially life-saving drug naloxone is too expensive to purchase for their clients and should be covered by Quebec's public health insurance.

This week, Health Canada approved naloxone for over-the-counter, non-prescription use in Canada, but its price – $145 for two single-use doses of the spray version – is too high for some clinics in Montreal to purchase the drug.

Jeremy Wexler, a social worker at a Montreal opiate-replacement clinic, was hoping his clinic would begin training families and friends of users on administering naloxone in case of an overdose.

But he was shocked when he found out about the price of the nasal spray version. 

"We felt like the nasal spray is a big advantage, but we had to back away," Wexler told CBC Montreal's Daybreak.

He said there's little question the spray version of naloxone would help save lives because it's much easier to administer than a syringe.

"[Users] come in with a parent or a husband or a wife who's terrified that the person's going to overdose," said Wexler. "It would be nice to offer naloxone nasal spray to family members or people who are around those using, so that they could feel better about those that are actively using."

An essential tool

Naloxone has proven to be an essential life-saving tool, as drug-related deaths continue to rise.

The Montreal regional public health authority has trained 200 people in community intervention centres on how to use the injectable form of the drug. The authority says as a result, seven overdoses were successfully prevented between June and December 2015.

Seven overdoses were successfully prevented with naloxone kits between June and December 2015, Montreal's regional public health authority reported. (Jacy Schindel/CBC)

In Alberta, the health authority reported naloxone kits containing the injectable version of the drug saved 408 Albertans from dying of fentanyl overdoses in one year.

Injection more effective?

However, not all front-line agencies working with injecting or inhaling drug users believe the nasal-spray version of naloxone is an improvement.

Cactus Montreal, the community organization that set up North America's first needle-exchange program in 1989, said while the nasal spray is easier to use, the injectable form has proven to be more effective.

It acts more quickly, and it isn't susceptible to potential barriers such as nasal blockages.

In an emailed statement, Cactus told CBC that increasing the availability of naloxone is key. It said the Quebec health insurance board (RAMQ) "should cover all necessary drugs. However, we do not have enough information on the drug to comment on whether or not Quebec should cover naxolone nasal spray."

Quebec Health Minister Gaétan Barrette told CBC Daybreak in a statement that he is currently evaluating whether RAMQ will cover naloxone, in either the nasal spray or injected format.