Lo­cal health depart­ment spon­sors free Nalox­one class to help re­verse opi­oid over­dose

Maryland Independent - - Community Forum - By TIF­FANY WAT­SON twat­son@somd­news.com

Peo­ple all over Mary­land are be­ing saved from opi­oid over­doses by a new drug: Nalox­one. It’s now be­ing made avail­able to Charles County res­i­dents at risk for an opi­oid over­dose or for those who are likely to be in a po­si­tion to wit­ness and re­spond to an opi­oid over­dose.

“Within the first three months of Charles County EMS hav­ing Narcan, they de­ployed it 87 times and we know the Charles County Sher­iff’s Depart­ment de­ployed it more than 20 times,” said Sara Haina, Charles County Depart­ment of Health di­rec­tor of sub­stance use ser­vices. “In the first 90 days of this year, EMS de­ployed Narcan over 100 times. That’s a lot of Narcan.”

The Charles County Depart­ment of Health, Divi­sion of Sub­stance Use Ser­vices is cur­rently spon­sor­ing free Nalox­one over­dose re­sponse train­ings at the Depart­ment of Health of­fices in White Plains. The train­ings are Mon­days from 6-8 p.m. and, at the end of each class, par­tic­i­pants are given a Nalox­one kit with two doses of med­i­ca­tion in an at­om­iza­tion de­vice, gloves and a mask to per­form res­cue breath­ing. Qual­i­fied trainees are en­ti­tled to re­ceive a cer­tifi­cate at the end of the class which can be taken to any phar­macy in the state of Mary­land to get a re­fill.

“Our goal in Charles County was to take away any of the bar­ri­ers of try­ing to save some­one else’s life,” said Dianna E. Ab­ney, M.D., Charles County Depart­ment of Health health of­fi­cer.

Nalox­one is a pre­scrip­tion med­i­ca­tion that quickly and ef­fec­tively re­verses an opi­oid over­dose. Narcan is the trade name of the drug, while Nalox­one is the generic ver­sion. Ac­cord­ing to the health depart­ment, Nalox­one — given in spray form — is only tem­po­rary and lasts only 30-90 min­utes, de­pend­ing on how much opi­oid a per­son has in their sys­tem. Nalox­one can me­tab­o­lize and if there are still opi­oids in the per­son’s sys­tem, he or she could still re-over­dose.

“Nalox­one takes a few min­utes to get the per­son to re­vive, but if the per­son does not re­spond within three or four min­utes then you can pro­ceed to give the sec­ond dose,” Ab­ney said. “This is why we say have an opi­oid abuse plan and en­cour­age friends and fam­ily mem­bers who are users to come get trained so that they won’t be alone dur­ing an over­dose.”

In many opi­oid over­dose sit­u­a­tions, peo­ple have only had to use one dose — while oth­ers needed three or four doses. Only two doses are in­cluded in the kit, so the health depart­ment re­quires that peo­ple call 911 be­cause the lo­cal EMS has ac­cess to more Narcan.

Haina’s pre­sen­ta­tion ex­plained how in­di­vid­u­als can rec­og­nize an over­dose, how to re­spond to an over­dose and other per­ti­nent in­for­ma­tion as a cer­tifi­cate holder. She said the health depart­ment has seen Nalox­one’s suc­cess with Charles County EMS and the Charles County Sher­iff’s Depart­ment us­ing the drug to re­verse an over­dose.

“We have an epi­demic go­ing on across the na­tion of opi­oid over­doses and there are too many fa­tal­i­ties,” Haina said. “We want to be able to put this in the hands of our com­mu­nity, but we also wanted to make sure that it was very safe.”

Opi­oids come from an opium flower and are de­fined as any drug that con­tains opium — nat­u­ral or syn­thetic, pre­scrip­tion or il­le­gal — taken by swal­low­ing or drink­ing it in pill form, or any way that you want to get it into your body. It is toxic. Opi­oids such as mor­phine, hy­drocodone, oxy­codone, oxycon­tin, per­co­cet, vi­codin and de­merol are pre­scribed by doc­tors to man­age a pa­tient’s pain.

“Opi­oids in ex­ces­sive amounts will sup­press your urge to breathe so the Nalox­one helps get air into the body,” Haina said.

Peo­ple who have over­dosed typ­i­cally demon­strate snor­ing, make loud gur­gling noises, are un­re­spon­sive, have pale skin, ex­hibit a slow, er­ratic pulse rate, have very shal­low breath­ing and could have their fin­ger­nail beds turn blue, in­di­cat­ing a lack of oxy­gen.

Users are not able to get high off of Nalox­one; it doesn’t have any side ef­fects for any­one who doesn’t have opi­oids in their sys­tem, and it has been deemed safe for chil­dren and preg­nant women. Haina said the only side ef­fect of Nalox­one is typ­i­cally opi­oid with­drawal.

A topic that stood out to par­tic­i­pants dur­ing Haina’s pre­sen­ta­tion is the Good Sa­mar­i­tan laws put in place, as of 2014, to pro­tect a per­son who seeks to pro­vide or as­sist in an al­co­hol- or drug-re­lated med­i­cal emer­gency. The per­son ad­min­is­ter­ing the drug can­not be ar­rested, charged or pros­e­cuted for pos­ses­sion or pro­vid­ing al­co­hol to a mi­nor, and it will not af­fect their pa­role.

“That’s a huge change,” Haina said. “Peo­ple who ad­min­is­ter Nalox­one to an in­di­vid­ual, be­lieved to be ex­pe­ri­enc­ing an over­dose shall have im­mu­nity and not held li­able for a good faith at­tempt to help some­one. No­body can come back to you and say you did the wrong thing.”

Christy Ring­gold, an In­dian Head res­i­dent, par­tic­i­pated in Mon­day’s class and was shocked to learn about the nu­mer­ous in­stances where Nalox­one was given to Charles County res­i­dents who over­dosed on opi­oids — just within the first 90 days of the drug be­ing ac­ces­si­ble in the County.

“I think it’s great that they have this class and that it’s avail­able for free,” Ring­gold said. “I’m re­ally glad the Good Sa­mar­i­tan Laws are put in place be­cause I know that’s why peo­ple don’t call any­body when over­doses hap­pen. They are hes­i­tant and scared to be ar­rested.”

Opi­oid over­doses have had a neg­a­tive ef­fect on Ring­gold’s close fiends and fam­ily as well, so the Nalox­one classes came avail­able at the right time for her. As a mom she wants to keep her kids safe and be­lieves she is ready to use the kit if nec­es­sary, but hopes she won’t have to.

“It’s all about sav­ing peo­ple’s lives and our hope is that the kit and class gives some­body the op­por­tu­nity to en­ter into treat­ment and re­cov­ery,” Haina said.

STAFF PHOTO BY TIF­FANY WAT­SON

Sara Haina, Charles County Depart­ment of Health di­rec­tor of sub­stance use ser­vices, ex­plains to par­tic­i­pants in the Nalox­one over­dose re­sponse train­ing class how the drug works.

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