Naloxone ( Narcan )

1. Naloxone (Narcan) A true opioid overdose antidote

2. Community Placement of Lifesaving Equipment

3. 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

4. How does it work? 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

5. 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

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

7. 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.

8. 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

10. 246 total 141 Accidental 61 Suicide 44 Undetermined

11. Jackson County accidental overdose data for the past 3 years:

12. Naloxone and Law Enforcement

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

14. 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

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

16. Project Lazarus Premises 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

17. The Rescue Medication Component >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

18. 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

19. Naloxone Future Directions • 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.