On Thursday, April 3, the U.S. Food and Drug Administration (FDA) approved a new medical device called Evzio that prevents opioid overdoes. An opioid is a chemical derived from opium and has been know to produce sedation and pain relief by binding to receptors in the brain, central nervous system and even in the gastrointestinal tract. Some common drugs you may have heard of that contain opioids include codeine, oxycodone, morphine and heroin. These drugs have also been associated with overdoses that can lead to death.
Evzio, the newly approved hand-held auto injector, is predicted to help save thousands of lives by preventing opioid overdoses (CNN, “FDA approves easy-to-use heroin overdoes antidote,” 04.04.2014). Evzio is administered in a single dose in the same manner as an EpiPen: It is injected into a muscle or directly under the skin. The main drug in Evzio, naloxone, is an opioid antagonist. Naloxone rapidly reverses the effects of heroin and other opioids, which can cause you to stop breathing.
However, James Rathmell, the chief of the division of pain medicine at Massachusetts General Hospital, still has major concerns. He noted that “there will be a false sense of security. Like, ‘O.K., I’ve got a naloxone pen, we can party all we want, no one is going to die’” (New York Times, “Hand-Held Treatment for Overdoses is Approved,” 04.03.14). But other experts in this field have suggested that complete access to this device by young adults, particularly minors, is unlikely, and hopefully, Rathmell’s concerns will not become a reality.
While family members, caregivers, and any non-medical personnel are allowed to keep this Evzio on hand and inject it, the new medical device does require a prescription. Despite this restriction, there has still been concern about improper administration of the drug, such as someone who is not actually overdosing from an opioid. Douglas Throckmorton, deputy director for regulatory programs with the FDA’s Center for Drug Evaluation and Research answered this question by stating, “If someone is given naloxone who is not overdosing from an opioid, the dose available in the Evzio device will not hurt them.”
A Vassar student commented that this new device reminded them of a “Pulp Fiction” scene when one of the characters is saved after accidentally snorting heroin. They noted it’s not quite the same concept, because in the movie they inject adrenaline into the heart, which they don’t think is realistic, but that it’s interesting such a similar concept was presented.
However, it should be noted that Evzio is not a permanent fix to an overdose solution. Proper medical care should be given as soon as possible. The injection of Evzio only temporarily reverses the overdose effects, and has been seen to bring out opioid withdrawal symptoms including nausea, vomiting, sweating, as well as increased heart rate and blood pressure that may lead to more serious medical issues (Washington Post, “FDA approves device to combat opioid drug overdose,” 4.3.14). Eric Strain, the director of the Johns Hopkins Center for Substance Abuse treatment and research, commented on the risks of injecting, stating: “There are risks and benefits to all medications, but in the big scheme of things, this is probably a valuable tool, especially if it’s used and provided in the context of improving access to treatment.”
Soon, every police officer in the state of New York will be trained to properly use the Evzio and be equipped to carry the medical device. During a test of this medical device in 2013, 563 people in Suffolk Country, New York received this injection, saving many from overdoses. New York will be first state in the nation to fully equip police officers, using $5 million in seized drug money to fund their Community Overdose Prevention (COP) program (CNN, “FDA approves easy-to-use heroin overdoes antidote,” 04.04.2014).
While I am mildly concerned that in 2013, there were so many cases of opioid overdoses in just one county of New York, I personally think that it is great that New York is pushing for all emergency personnel, like police officers, to be trained and equipped with this new device. Evzio may not be perfect, but often it is police officers, not medical professionals who arrive on scenes where medical treatment is needed first, and the police officers are not always properly trained to deal with those situations. Because of the training in Suffolk County, 563 lives were saved.
And while I also believe Rathmell does make a valid point in suggesting that people may have a false sense of security that they won’t ultimately die due to an overdose because this will revive them, I think there are also a lot of people who simply need help with the pressure of trying something once and not being educated on what might happen or even thinking that one drug is something when it’s actually something else. People sometimes make poor choices in all aspects of life at times. No matter what, when someone overdoses and loses their life it is terrible: loved ones, family, friends all become heartbroken.
For now, I am a supporter of the device, hoping that Rathmell is wrong. Maybe the advancement of the device will bring to light more information and education about opioid overdoses and risks to people. I am hoping to see the that reported number of times the device is used will decrease, but only time will tell.
—Delaney Fischer ’15 is a neuroscience major.