The Brookhaven and Dunwoody police departments are among the dozens of public agencies to have received free doses of naloxone, a lifesaving opioid-overdose antidote, from a Virginia-based pharmaceutical company. But a recent investigation into the company’s charity program found the goodwill was limited by the fact that some of those doses were within months of expiring.
Four years ago, when Kaleo started giving away more than 330,000 naloxone auto-injectors, the Dunwoody and Brookhaven police departments were among the first law enforcement agencies to apply for the free antidote. They each received hundreds of doses of the lifesaving drug. They each armed their officers with medicine that revives overdose victims. They each saved lives.
But both departments were among at least nine police departments that, according to an investigation from STAT News, had received Evzio naloxone auto-injectors that were on the verge of expiring. Pharmacists typically dispense naloxone with over a year left on its shelf life. But the investigation found that some departments received free naloxone anywhere from four to 11 months away from expiring.
Drug charity programs are a tactic used by pharmaceutical companies to justify price hikes and get rid of product that pharmacies will no longer stock. Kaleo — the subject of a congressional probe for raising the price of its Evzio product to $4,500 for a two-pack — has earned a plug from President Trump for donating naloxone. Kaleo spokesperson Brian Ellis told STAT that the company attempts “to make donations with the understanding that it will be used quickly, not stockpiled.”
“Kaleo would much rather help save a life than throw an effective product away,” Ellis said.
While federal and Georgia laws do not prohibit the practice of donating soon-to-be expired drugs, some experts, like Leo Beletsky, an associate professor of law and health sciences at Northeastern University, believe the pharmaceutical practice is unethical — the equivalent of a restaurant donating wilting lettuce to a food bank. The effectiveness of naloxone may decrease as the antidote nears its expiration date, potentially requiring multiple doses to reverse an overdose, according to pharmacists.
“We were grateful, but these were drugs that likely couldn’t be sold,” said Sgt. Robert Parsons, the Dunwoody Police Department’s naloxone coordinator. “If departments receive the donations, and it runs out, you’ve created the expectation in the community that officers are carrying the product and that, if someone is overdosing, you can call 911.”
Prior to receiving free Evzio in March 2015, Brookhaven officers hadn’t used naloxone in the field to reverse opioid overdoses. Officer Carlos Nino, a spokesperson for the Brookhaven Police Department, said the department has received five Evzio donations including a total of more than 700 auto-injectors. One of those batches, he said, was received six months away from expiration. Since then, Kaleo has provided auto-injectors that last more than a year, Nino said. The department still uses the auto-injectors to save overdose victims.
“Officers are just amazed at how it goes from shallow breaths … to, boom, next thing you know, they’re up on their feet,” Nino said.
Over the past four years, Brookhaven has deployed naloxone nearly two-dozen times to overdose victims.
In early 2016, Brookhaven Police Chief Gary Yandura only talked about the positives of the donated naloxone when he was quoted in a Kaleo press release: “Anytime there is a chance for a police officer to save a life they should have the tools to help make them successful. Evzio has been that tool. We use it to help save lives and give second chances.”
Kaleo, for its part, has encouraged some agencies to plug the free product, providing police chiefs with a stock press release for its potential use. In other cases, some departments have had to sign a confidential agreement that restricts officers from referring to Evzio by the brand name of its top competitor, Narcan, a nasal spray manufactured by Adapt Pharma.
In October 2015, the Dunwoody Police Department received its first batch of Evzio auto-injectors, which expired the following April. When a second set arrived, Parsons looked at the box, shocked to find that the product would only last for four months.
Yet that hasn’t stopped Dunwoody from getting overdose calls. Instead of purchasing Kaleo’s pricey product, Parsons said the DPD instead invested in the purchase of Narcan nasal spray, a cheaper naloxone product that costs around $150 for a two-pack. The department now spends about $5,250 every two years stocking up on naloxone, he said. Overall, Dunwoody officers have administered naloxone in nearly half of its 39 overdose calls since 2015.
“To say you don’t have naloxone anymore is tough,” Parsons said. “You need to be ready to take on that expense in one way, shape, or form.”
Editor’s Note: Max Blau is a freelance reporter based in Atlanta. Last month, he investigated the issue of soon-to-expire naloxone donations for the healthcare website STAT News; this article focuses on local police departments affected by the issue. Earlier this year, he wrote our exclusive four-part series “Coping with a Crisis: Opioid Addiction in the Suburbs.”
The subjects of other installments of “Coping with a Crisis” included: families using obituaries to tell the harsh truth of loved ones’ overdose deaths; a Dunwoody man who runs treatment facilities for opioid users after surviving eight overdoses and facing prison time; and how local schools decide whether to carry an antidote to opioid overdoses, which kill far more schoolchildren than mass shootings do.
The Reporter’s podcast “Reporter Extra” took a deeper look at the opioid crisis with Blau and Dunwoody Police Sgt. Robert Parsons.