Time for a pop quiz: How many of you know how to buy Narcan? Where would you get it if you wanted it? How much would you have to pay?
Harder questions than you thought, right?
As much as the city has advocated for average citizens to carry the overdose-reversing antidote — with ads on buses, subways, and street corners — and despite a 2015 state "standing order" that allows pharmacists to dispense the lifesaving spray without a prescription, many pharmacies are still slow to climb on the Narcan train.
So slow, in fact, that Philadelphia City Council has gotten on the case.
And as the adage goes, if you've let something go long enough that Philadelphia City Council starts to notice, something has gone wrong.
A bill, sponsored by Councilman Bobby Henon and moving through Councilwoman Cindy Bass' public health and human services committee, would hit pharmacies that don't carry at least two doses of Narcan with a $250-a-day fine. The thinking is that pharmacies are the front lines — the most sensible places for the most people to pick up the spray.
But as my colleague Marie McCullough reported this week, city health officials estimate that a quarter of Philly pharmacies — about 100 around town — still don't carry Narcan.
And that's inexcusable.
There's no easy answer to this epidemic. But while we search for those answers, Narcan is the antidote that keeps people alive. The city has handed out 57,000 doses of the drug since last year, and that's probably why overdoses are holding steady this year. It's still something like 1,200 deaths, still an unconscionable amount, and still the most of any big city in the country. But at least more people aren't dead.
"We're trying to make carrying Narcan, unfortunately, just a normal part of what people do," city Health Commissioner Thomas Farley told me. He said the department still fields complaints from customers who can't find it on the shelves of pharmacies.
While the city holds Narcan trainings, they're not necessary. Saving a life is as easy as using Flonase, the allergy spray. (Public and private insurance usually covers the drug, which otherwise starts around $130 for two doses or around $35 for the generic, naloxone.)
In a decidedly unscientific survey of my own, I called around to a dozen or so pharmacies — from South Philly to the Northeast — mostly smaller, independent stores, the sort that the city found were more reluctant to carry the drug.
Most had it stocked. Three said nope. A couple of others said they could place an order and have it by tomorrow.
Richard Ost, owner of Philadelphia Pharmacy in Kensington, has been advocating for his colleagues in every neighborhood to carry Narcan.
"There's still a taboo in some people's minds," he said. "That it's not in my area and not my problem."
Stigma doesn't help, he added, remembering a colleague who said: "I don't want to encourage the wrong people to come in my store."
The way Ost sees it, while more pharmacists are seeing the light, Henon's bill is a good kick in the pants. It forces the issue.
Daniel Ventricelli, assistant professor at the Philadelphia College of Pharmacy, agrees.
"At the end of the day, just having it available doesn't mean it's being utilized," he said. "The next step is providing further education to pharmacists to help them identify who would be good candidates for needing it or someone who could be in a good position to help someone with it."
Pharmacists should be handing it out like candy. Doctors should be giving it out with every pain-medication prescription they fill. And pharmacies should be advertising it next to the sign for flu shots. That's in the bill, too.
This bill, expected to be approved soon, is a good one. Especially on this city council. Henon, for one, has been content to push solutions away from his neighborhood, and at a Council hearing earlier this year, he and others displayed such a basic lack of knowledge on the crisis that they couldn't finish the meeting. Too much time was wasted because health officials and doctors had to walk them through the basics of a public health catastrophe.
I carry Narcan everywhere now. It just makes me feel safe.
I've had to use it twice while reporting in Kensington. I don't say that to sound heroic — it's just that anyone who spends time in Kensington will eventually have to reverse an overdose.