"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."
What happened to evidence based practice? Do some research on harm reduction, and you'll see that it is more effective than moral outrage at reducing the costs to individuals and society that are associated with illegal drug use.
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.
What are the chances that a guy who just watched his buddy OD on heroin will call 911?
What are the chances that a mother or father who just found their son or daughter ODd on heroin will fail to call 911?
There are a lot of hypotheticals, but I think the act addresses a lot of the potential pitfalls.
A state issued summary reads, "The act requires the department of health to establish a three year statewide opioid antagonist pilot program for the purpose of distributing opioid antagonists to persons at risk of overdose, and to family, friends and others in a position to help such persons. The department shall purchase, provide for the distribution of and monitor opioid antagonists distributed through the pilot program. It shall also report to the General Assembly regarding the cost and effectiveness of the program....[Act 75] allows health care professionals acting in good faith to prescribe, dispense and distribute an opioid antagonist to a person at risk of experiencing an opioid overdose or to a family member, friend or other person in a position to help such a person, so long as the recipient of the opioid antagonist has completed a prevention and treatment training program approved by the department of health. Unless acting recklessly, with gross negligence or intentional misconduct, a health professional who prescribes, dispenses or distributes an opioid antagonist under this section shall be immune from civil or criminal liability regardless of whether the opioid antagonist was administered by or to the person for whom it was provided. The act dictates that, unless acting recklessly, with gross negligence or intentional misconduct, a person who has received an opioid antagonist is free from civil or criminal liability for administering it to a person who he or she believes is experiencing an opioid related overdose. If medical assistance has not yet been sought, a person shall call emergency services after administering an opioid antagonist."
[h=1]Overdose Prevention[/h] Drug overdose is the leading cause of accidental death in the United States, causing more deaths than motor vehicle crashes.
According to the Centers for Disease Control and Prevention (CDC), overdose rates have increased roughly five-fold since 1990.The CDC attributes the rise in drug overdose deaths to a higher use of prescription painkillers and increasing numbers of overdoses of cocaine and prescription sedatives. In 2008, the most recent year for which data is available, the CDC reports 36,500 poisoning deaths in the United States.
Providing overdose prevention, recognition, and response education to drug users and their neighbors, friends, families, and the service providers who work with them is a harm reduction intervention that saves lives. Heroin and other opioid overdoses are particularly amenable to intervention as risk factors are well-understood and there is a safe antidote – naloxone.
[h=5]Drug Overdose Prevention & Education Project (DOPE)[/h] Drug Overdose Prevention & Education Project (DOPE) is Harm Reduction Coalition’s west coast overdose prevention initiative. DOPE provides overdose prevention education and training in shelters, jails, treatment programs, and SRO hotels. Collaboration with the San Francisco Department of Public Health enables DOPE to distribute naloxone kits throughout the city, including at syringe access programs throughout the city. DOPE also provides advocacy and capacity-building to programs looking to incorporate Opiate Overdose Prevention Programming throughout California.
[h=5]Skills & Knowledge on Overdose Prevention (SKOOP)[/h] Skills & Knowledge on Overdose Prevention (SKOOP) is Harm Reduction Coalition’s east coast overdose prevention initiative. It is funded to train heroin users along with their peers, allies, friends and family members on OD prevention, recognition and response, as well as on how to use naloxoneto reverse opioid overdose. After receiving training, participants are given their own naloxone kits (including prescriptions). SKOOP also provides training of trainers sessions with providers and drug users as well as technical assistance for staff of local CBOs.
SKOOP is also working to address the gap in medical providers prescribing buprenorphine as a means of treating opioid addiction. Opioid substitution treatment is closely linked to overdose prevention. Staff are developing and implementing an expansive training curriculum for health care providers as a means of increasing capacity to prescribe buprenorphine.
This is kinda like those safe injection zones. You know people are going to use regardless, so they go hand out new needles, and provide a safe environment for users to inject. Enabling? Sure, but if you acknowledge the fact that these people are just going to keep using, no matter what, you might as well try to limit risk.
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.
The "call 911 and let EMS handle it" plan is what we already do, and it doesn't work very well, it only takes a couple of minutes of anoxia to cause anoxic brain injury, far less time than it takes EMS to respond even in the best situations.
Education is a big part of these programs, which includes the fact that the Opiates last longer than the Narcan, and that you're essentially putting the patient into instant withdrawal, so it's reasonable to include a warning that use of Narcan is likely to result in agitation, and that failure to use it is likely to result in death.
Yes, I have seen Narcan administered. It can be ugly, but less so than the other outcome.
With respect, who on earth cares if the victim is angry or violent? You don't think their cohorts have been around angry violent people before? Their friends are hanging out with drug abusers, they have seen violence, believe me. And if it is Mom or Dad, you don't think they would put up with some of that to save their kid's life? Listen, the bottom line is Narcan availability is going to save lives and that's it. That is all I need to know. Frankly, I can't even believe this is even up for debate.
So what is this really about? The real debate, the one few here are going to voice aloud but that some are thinking, is "are these lives worth saving?" After all, they are "just junkies," right? "Why should we dedicate more resources to save them?" We have a very big faction of people in this country who are voicing daily the opinion that they do not believe that people they consider less than themselves (less white, less educated, less English speaking, less income earning etc) deserve as much health care as they have for themselves, so I imagine most of those very same people object to Narcan for addicts. I am sure they are content to let them die, or better yet, to end up in one of the for-profit prisions in which they have, no doubt, heavily invested.
Chicago has done a pilot project which reduced Heroin/Opiate OD deaths by 20% in it's first year, other programs have seen reductions of up to 50%, I'm not sure how that's a bad thing.
Bad thing is that they'll end up in the hospital again, and again. Most likely medicaid / no insurance = taxpayer money.
Give them drugs, let them die. Now nobody has to pay for them.
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.[/quote']
That's what I was thinking...if we can use an epi-pen and call 911 to save lives, then this can occur the same way; although, epi-pen is sooo much sexier than the narcan pen...everyone loves it!
Yes, I have seen Narcan administered. It can be ugly, but less so than the other outcome. With respect, who on earth cares if the victim is angry or violent? You don't think their cohorts have been around angry violent people before? Their friends are hanging out with drug abusers, they have seen violence, believe me. And if it is Mom or Dad, you don't think they would put up with some of that to save their kid's life? Listen, the bottom line is Narcan availability is going to save lives and that's it. That is all I need to know. Frankly, I can't even believe this is even up for debate. So what is this really about? The real debate, the one few here are going to voice aloud but that some are thinking, is "are these lives worth saving?" After all, they are "just junkies," right? "Why should we dedicate more resources to save them?" We have a very big faction of people in this country who are voicing daily the opinion that they do not believe that people they consider less than themselves (less white, less educated, less English speaking, less income earning etc) deserve as much health care as they have for themselves, so I imagine most of those very same people object to Narcan for addicts. I am sure they are content to let them die, or better yet, to end up in one of the for-profit prisions in which they have, no doubt, heavily invested.
Anna Flaxis, BSN, RN
1 Article; 2,816 Posts
What happened to evidence based practice? Do some research on harm reduction, and you'll see that it is more effective than moral outrage at reducing the costs to individuals and society that are associated with illegal drug use.