Not just for medics: Drugs that reverse opioid overdoses are being pushed to the masses

BALTIMORE – After two decades of sending a needle exchange van around this city ​​officials here last year started to do something new. They do not just deliver clean syringes; they would distribute the antidote to opioid overdose plaguing local communities.

When the rolls go through Baltimore these days, one member of the health department of the city teaches newcomers how to deliver naloxone medicine saves lives that can reverse the effects of a opiate overdoses and gives them a free kit containing two doses.

Similar scenes are playing out in recovery centers, school guidance and town meetings across the country, communities are trying to prevent deaths from opioid overdose that quadruplicate in the last decade and half. Some advocates liken know how to use naloxone to know how to perform CPR, granting someone the opportunity to save the life of another.

“It was this gradual process of expanding the presence of the drug in the community that may be available when needed,” said Scott Burris, director of the Center for Health Law, Policy and Practice, Faculty of Temple law.

Naloxone outtreach
An aerosol naloxone provided by the needle exchange van, is assembled.
Naloxone outtreach
Harris, left, trains others how to use naloxone in the van.

In May, the Ohio Department of Health launched one full advertising campaign with posters encouraging people to carry naloxone. Fort Lauderdale, Fla., Recently changed its health plan for policies of insurance naloxone for municipal employees and their families. Inmates in the states of New Mexico North Carolina naloxone kits are being given when released from prison.

And in the last year North Carolina and Pennsylvania joined the growing list of states with standing orders for naloxone – general requirements allow residents to collect at a pharmacy without a prescription itself.

for at least two decades, advocates have pushed for naloxone for people with drug addiction and their families, and in recent years, campaigns have focused on equipping police forces with the antidote. These groups remain the main hearings efforts.

However, some initiatives are also trying to reach people, whether they use opioids or know someone who does, just in case they find a overdose victim passed out in a car, unconscious in a bathroom restaurant or die on their own front lawn.

Naloxone outtreach
A needle exchange van Department of Health of the City of Baltimore in West Baltimore.

Here in Maryland, a change in state law allowed municipalities to issue its own standing orders, and Dr. Leana Wen, Baltimore’s health commissioner, signed a year past. The city also has a training program online.

“I narcan in my bag right now, because you never know,” Wen said in an interview, using one of brand names of drugs .

In 2001, New Mexico changed its laws to make it easier to get naloxone, and since then, every state except Kansas, Montana and Wyoming has changed policies to improve access to naloxone, according to network for Public Health Law. Many states allow people to get prescriptions if you are not the intended user and provide certain legal immunity to people who call 911 and administer naloxone, even if they have illegal drugs in them. Now advocates are urging health officials in more states to sign standing orders.

“It may not be a friend or family member, but might just be a person spends on the bus,” said Evan Hoessel Care of Albuquerque Healthcare for the Homeless, which has provided training for church groups.

In general, policies helped increase the amount of naloxone distributed by pharmacies in more than 1,100 percent since late 2013 to mid-2015, according to a study of 2015 US health officials. The Centers for Disease Control and Prevention Diseases recommended this year doctors consider offering naloxone when prescribing opioids for pain if there are certain risk factors such as substance abuse before or if the dose it is particularly high.

Shirley Buntain, a mother of four in Louisville, Ky., I got trained to use naloxone last summer because she has a child who uses illegal substances. But she said it might have to save others, and naloxone and carried in a backpack wherever he goes.

“I trained for him, but also trained for people who do not want to admit that their child had a problem,” said Buntain, 54, an office manager in a garage. “I went from being a mom carrying an EpiPen bee allergy to be a mother carrying an antidote. It is not a place I never imagined being in”.

Naloxone outtreach
training sessions nasal spray delivery naloxone last only a few minutes.

naloxone, which was Initially approved by the Administration of Food and Drug Administration in 1971, which works by blocking opioids act on receptors in the brain and reverses the respiratory depression caused by overdose. Or is sprayed into the nose or injected into a muscle, and rescue teams sometimes have to use multiple doses to revive someone.

Even when used on someone who had not taken an overdose of opiates, naloxone has few side effects and is itself is not addictive. It does, however, produce acute withdrawal symptoms, and many people who are agitated and revived awakening “ ill drug .”

“That shit works great,” he said 30-year-old Andrew Chamberlain one day last month as he left the truck needle exchange here with clean syringes. “By the time you put in the second [dose] they are jumping up.”

naloxone Chamberlain said he had used several times in the past year fellow drug users and drug refills in methadone clinics, among other places.

“I’ve used three times in the last week,” intervened a woman standing on the sidewalk, which was full of needle caps. “Once in the alley, once in the alley there,” he said, pointing to alleys in which some people vanished after they fell from the truck.

The woman, combing her wet hair soaking, added: “I’ve had to use me.”

The FDA says that is working with naloxone makers to take measures so that the antidote available over the counter, so it would not be necessary even a permanent order. The agency also launched contest last month by people develop an application that could connect people with overdoses with people nearby who are carrying naloxone.

(if manufacturers naloxone want to apply to naloxone available over the counter is a different story. One, Kaleo Pharma, STAT said he has no plans to get your autoinjector naloxone approved for use over-the-counter .)

Critics of a wider access to naloxone argue that motivates people to continue using drugs. They also note that does not get to the root of drug addiction :. It saves people from overdoses, but does not prevent them

“Naloxone not really save lives limited thereto extends until next overdoses,” Maine Governor Paul LePage wrote in April when he vetoed a bill that would have made it more easy to get naloxone (the legislator annulled the veto ).

Naloxone outtreach
People who are trained to use naloxone receive a card so they can get refills at local pharmacies.
Naloxone outtreach
A man leaves the needle exchange van after getting clean needles and learn to use naloxone.

public health advocates argue that such views reflect the stigma against people struggling with addiction; also they note that exaggerates are often caused when users inadvertently take heroin mixed with more potent opioids as fentanyl or carfentanil .

But even if naloxone did encourage more risky behavior, experts say that many more people than it could endanger saved. Cities and states report saved hundreds of lives each year. A recent survey 140 organizations found that the laity had invested more than 26,000 overdose 1996-2014; more than 80 percent of the people who saved someone with naloxone were fellow drug users.

Karen Johnson, Louisville, Ky., Learned to use naloxone one night last year at a seminar drug information. His son was in rehab at the time, but until then, had never heard of narcan.

Two weeks later, his son was home and overdose. She naloxone injected him in the leg as he was turning blue – “I dug hard,” she said – and saved his life. Now the nasal spray is kept at home.

“It’s just a hell world, being thrown into the world of addiction,” he said. “I’m sure there are all kinds of criticism of naloxone, but it’s definitely something I always have.”

manufacturers naloxone have donated thousands of doses to communities and offer discounts to first responders, but the increase of cost of the drug – combined with the growing need – has forced some programs to cut in what they can buy.

Emily Metz, who coordinates program naloxone training in the Cleveland area, said the price of the nasal spray purchased program has gone from $ 12 to $ 30 per dose in recent years . The program is changing to an injectable version can be purchased for around $ 12

In Baltimore, the health department is now paying $ 37.50 per dose compared to $ 25 last summer. Each kit will be disseminated to needle exchange costs the city $ 75

For people who collect kits utility of the city, the drug can be very valuable.

On a recent afternoon, those who came through their training one-on-one all putting great attention, nodding and saying an understanding “OK” as the instructor demonstrates each step on a mannequin.

like a man prepared to leave the training, clean needles and naloxone kit in hand, he said: “I hope not to have to use these things.”

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