The nation’s second-largest public health crisis has been obscured by the shadow of COVID-19. But drug overdoses continue to kill Americans at historic rates, as our governments and communities simply aren’t doing enough to prevent and treat addiction.

Those reforms have to come. But in the meantime, we need to do everything in our power to keep people from dying from this horrible disease.

However, a nationwide shortage of the overdose-reversing drug naloxone is now making that effort more difficult across the country. It’s also uncovered a flaw in how the life-saving drug is distributed.

The shortage is the result of an unspecified manufacturing issue at Pfizer – one, the company says, that is unrelated to its production of the COVID vaccine. The issue came up in April, Pfizer said, and could continue until February.

Pfizer isn’t the only manufacturer of naloxone, but it is the only one of significant size that offers the drug to harm-reduction programs at a discount, The Washington Post reported last week. Without the supply from Pfizer, these groups will have to pay market price, forcing them to get by with fewer doses or shift limited resources to pay the higher cost.

As a result, the Post reports, some harm-reduction programs are having to decide which places get naloxone and which don’t. Some programs in Maine are setting limits on how much they distribute, too, the Press Herald reported this week.


An official with the national buyers’ club that worked out the deal with Pfizer told the Post that their shortfall in naloxone – an estimated 250,000 doses – could result in around 11,000 additional deaths because the drug wasn’t where it needed to be.

While the shortage hasn’t affected Maine as much as elsewhere, it should be a warning: Making the supply of a life-saving drug dependent on one source is not sustainable. Pfizer should be applauded for taking part in the program when others don’t. But one company’s manufacturing issue alone should not be such a crisis.

The shortage is being felt particularly hard in communities where governments and the general public haven’t embraced harm-reduction efforts – that is to say, communities where harm-reduction efforts are some of the only evidence-based programs around.

These programs need more help than they are getting, in those communities and every other one. Fewer than half of the recipients in the buyers’ club get federal money, even if they are, in most places, the best way to ensure that people struggling with addiction stay alive until they are able to get long-term care.

Naloxone works. In the first half of the year in Maine, the state reports, naloxone was used more than 2,000 times, each shot bringing someone back from the brink of death.

There were a record 93,000 overdose deaths in the U.S. in 2020. How many more would there have been if naloxone wasn’t available? How many more lives could have been saved if it were more widespread?

For that matter, how many more lives could be saved if harm reduction in general were embraced more widely? Indeed, in the absence of naloxone, fentanyl strips, which can tell someone whether their drugs contain the deadly opioid, are all the more important, helping someone avoid an overdose in the first place.

The addiction epidemic is enormous, and it is growing. Every tool possible should be used against it.

After all, the tragedy is not only in the thousands of U.S. overdose deaths every month – it’s in not doing everything we can to prevent them.

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