North Carolina harm reduction providers - which includes people who use drugs, people with living experience with substance use, health care providers, public health workers, policy makers, research professionals, and advocates for the health and safety of drug users - implore our state and counties to ensure that standard-dose naloxone formulations are available to community-based harm reduction groups and other statewide agencies offering syringe service programs. Specifically, we want continued intramuscular .4mg naloxone available as well as Harm Reduction Therapeutics’ 3mg intranasal naloxone RiVive as the primary options for distribution.

At this time, and in alignment with other experts from across the US, we do not recommend the use of any high-dose (above 4mg) or long-acting overdose reversal agents in North Carolina by community groups, treatment providers, EMS and other first responders, or bystanders with access to naloxone. We also support the Call to Action published from the national Compassionate Overdose Response Summit.

It is a fact that when it comes to overdose reversal more naloxone is not better naloxone. Companies are pushing higher-dose and longer-acting options that are going to put the most vulnerable populations at high-risk for harmful precipitated withdrawal. High-dose naloxone products like Kloxxado and other opioid antagonists such as Nalmefene may induce longer and more painful withdrawal that is not only unnecessary, but inhumane. We have had naloxone in its original form since the early 1970s, and newer formulations like RiVive 3mg intranasal naloxone are just as effective at knocking opioids off the receptors and, with rescue breathing occurring in tandem, can restore life. By signing this petition, we the people and organizations strongly encourage our state and local leadership and  policy makers to give all responders and communities these safe, compassionate choices that sustain and support the people we love.