Naloxone (Narcan) A true opioid overdose antidote

Community Placement of Lifesaving Equipment

Naloxone  Overdose antidote  Administered via injection or nasal aerosol  Onset of action 3-15 mins  Duration of action: mins Image courtesy of Prescribe to Prevent

 It replaces the heroin or pain pills on the nerve receptors in the brain.  That includes the receptors that are associated with breathing and pain.  People can “come back from the dead,” alert but very uncomfortable How does it work?

Senate Bill 384 – “The Naloxone Bill”  Passed June 6, 2013  Allows bystanders to receive training to administer naloxone in an overdose situation and gives them the right to administer  Similar to “EpiPen” and “glucagon” Image courtesy of Talking Drugs

Jackson County Oregon Population 206,412 (Jackson County averages over 250,000 opioid prescriptions per year)

We’re Number One!  Oregon leads the nation in inappropriate use of prescription pain killers for adults.  Jackson County has one of the highest per capita opioid prescribing in the state.

Overdose deaths in US compared to motor vehicle accidents

9 Unintentional or undetermined prescription opioid and heroin overdose death rate by year, Oregon,

Jackson County accidental overdose data for the past 3 years:

Naloxone and Law Enforcement

 Inexpensive  Safe  Easy to administer  Mortality drops in communities utilizing naloxone: Why Naloxone? 37-90%

Training  Can be done in 20 minutes  State approved video exists:  m/watch?v=FZpgjRBby_M m/watch?v=FZpgjRBby_M  Simple naloxone kit can be provided Image courtesy of the Harm Reduction Coalition

Project Lazarus  Community-based overdose prevention in rural North Carolina (Wilkes County)  Addressing:  Supply reduction  Demand reduction  Harm reduction

 Opioid overdose deaths are preventable  All communities are ultimately responsible for their own health  Active participation from a coalition of community partners is required for a successful public health campaign Project Lazarus Premises

 >50% of OD deaths in Wilkes Co were occurring at home.  EMS was not being called, because bystanders did not recognize the signs and symptoms of opioid OD and were fearful of legal action  The community established bystander naloxone and education.  overdose death rate dropped from 46.6 per 100,000 in 2009 to 29.0 per 100,000 in 2010 The Rescue Medication Component

Portland’s Experience  Outside in – Standing orders for training and distribution  Administered through needle exchange program  Within 3 months, ~300 trainings given, ~100 reported administrations  0 reported adverse events Image courtesy of Google images

 Train more community members to reverse overdose  All Law Enforcement  Friends, family, professionals  Recruit local pharmacies to dispense naloxone for trained community members  C o-prescribe Naloxone with opioids. Naloxone Future Directions