"Wayne Bassett, a Vietnam War veteran, unintentionally injected himself with a lethal dose of heroin in 2001 at his Danville home and died alone, excepting the family dogs.
His wife Nancy Bassett, a heroin addict herself, was in Connecticut serving nine months in rehab at the Federal Correctional Facility in Danbury. Her crime: transporting narcotics across state lines, a federal offense."
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"She recounted the experience this week from her tiny office at the recovery center upon news that Narcan, an overdose antidote long administered by doctors and EMTs, is going mainstream. A new state of Vermont pilot program aims to distribute Narcan to addicts, their friends and family."
I personall think it is a good idea. Sometime other users do not cal 911 out of fear of being caught. So of their buddy injects a lethal dose? Bye bye and let's hope someone else finds you. Some steal narcan out of the ambulances anyway.
I have heard about this in the NW. We can look at it in several ways:
1) Addicts need (deserve?) to experience the consequences of their addictions and giving narcan is no long term solution. (BTW I do not agree with this).
2) Liability involved in prescribing a medication that is designed to be given to a potentially unwilling patient by an untrained person (this is what most docs are bringing up).
3) The cost savings in just 1-2 visits to the ED is worth any cost in handing it out like candy.
4) The saving of lives in people giving it when they would not otherwise be willing to call 911, or in the process of the drive to dump them in the ED driveway.
My understanding is that they would be giving this intranasally with an atomizer mister (but it needs to be hand assembled and it is not commercially available). It would be great if some company would make a nasal spray (thinking of Afrin) but filled with narcan. Of course we have always asked for a spray room mister filled with Ativan but we never got that either LOL.
I'm for it. #1, it isn't as though the victim is going to use it on him or herself in most cases. More likely, a friend or family member is going to administer in order to save their loved one. #2 Narcan ruins the high, so they aren't going to purposefully OD with the knowledge the can save themselves.
The bottom line is that it has the potential to save lives (and keep down costs associated with ODs, such as ICU stays -for the Scrooge Mc Ducks out there, lol). I fail to see a down side.
Specializes in Oncology; medical specialty website.
I'm for it. #1, it isn't as though the victim is going to use it on him or herself in most cases. More likely, a friend or family member is going to administer in order to save their loved one. #2 Narcan ruins the high, so they aren't going to purposefully OD with the knowledge the can save themselves.
The bottom line is that it has the potential to save lives (and keep down costs associated with ODs, such as ICU stays -for the Scrooge Mc Ducks out there, lol). I fail to see a down side.
One of my concerns is that the family/friend may not understand that the patient could re-narcotize; the friend/family member may think that one dose will be sufficient, when the patient may actually need more than one.
They also need to be prepared for the pt. to be agitated, even violent. I saw more than one dissatisfied customer try to take a swing at staff when their high was wrecked.
One of my concerns is that the family/friend may not understand that the patient could re-narcotize; the friend/family member may think that one dose will be sufficient, when the patient may actually need more than one.
Instructions for Epi-Pens include calling 911 if the pen is used. Narcan would be no different. The family/friend would use the Narcan for immediate rescue and call 911, same as with epi.
Don't be so sure, unless you've actually been there. Addiction is a horrible disease and when your loved one actually is addicted to heroin and needs help its not as easy as "not having contact". Just saying.
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I am sure.
And, yes, the narcan should some with a warning about the vomit and rage that may accompany its administration.
I always thought this was common practice, until I moved to a different state. I also fail to see the downside. It has a great potential to save lives, but no potential to cause harm. People are not unteachable- make it available with the understanding that its effects are temporary and it is to be used UNTIL emergency help arrives. If someone experiences a lethal overdose, having narcan available can only help them. It is not our place to judge whether they deserve that help or not- that is no one's place to judge.
I'm for it. #1, it isn't as though the victim is going to use it on him or herself in most cases. More likely, a friend or family member is going to administer in order to save their loved one. #2 Narcan ruins the high, so they aren't going to purposefully OD with the knowledge the can save themselves. The bottom line is that it has the potential to save lives (and keep down costs associated with ODs, such as ICU stays -for the Scrooge Mc Ducks out there, lol). I fail to see a down side.
Absolutely agree.
I've seen a similar program in use. The person administering usually calls 911 after doing so in order to get the OD under observation for rebound sedation depending on their heroin dose. It works and it saves lives.
Harm reduction and decriminalization is the way to really get some work done. That is the only way addicts will be able to be treated appropriately -- when we stop wasting resources on incarcerating thousands. But that's another rant
Specializes in LTC, assisted living, med-surg, psych.
I have to wonder if the proponents of this idea have seen very many people Narcan-ed. I have, and believe me, even nice, normal people who are just over-sedated post-op can come roaring out of that stupor madder than a wet cat---swinging, leaping, fighting, cursing etc. because they are still confused and the sensation that has just hit them is PAIN.
Now, if trained staff sometimes get caught off-guard and have difficulties handling patients in that state, what on earth makes anyone think that the average layperson could? We also know how to give Narcan safely, how to titrate it to the patient's response---this is not a skill the average family member (let alone a fellow addict) would know how to do, especially not during an emergency. Far better to call 911 and let EMS handle it.
All in all, handing out Narcan is a terrible idea, IMHO of course.
According to the article, EMS response times in this area can be slow. Waiting for EMS to arrive could mean the difference between life and death. Also, the medication will be accompanied by a tutorial, which will, I am sure, cover what to expect when giving the medication.
applesxoranges, BSN, RN
2,242 Posts
I personall think it is a good idea. Sometime other users do not cal 911 out of fear of being caught. So of their buddy injects a lethal dose? Bye bye and let's hope someone else finds you. Some steal narcan out of the ambulances anyway.