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