naloxone (narcan) a true opioid overdose antidote
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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: 30-45 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 OregonPopulation 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, 2000-2012
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120
1
2
3
4
5
6
7
8
9
Herioin rate per 100,000 Prescription opioid per 100,000
Year
Ra
te p
er
10
0,0
00
2004 2005 2006 2007 2008 2009 2010 20110
5
10
15
20
25
30
35
40
45
50
Overdose Deaths 2004-2011 Jackson County Oregon
Undetermined
Suicide
Accidental
# D
eath
s
246 total141 Accidental61 Suicide44 Undetermined
All Rx opioids methadone alone Heroin0
5
10
15
20
25
201120122013
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:
https://www.youtube.com/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
Co-prescribe Naloxone with opioids.
Naloxone Future Directions
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