Accessing naloxone (Narcan®), a life-saving opioid reversal agent, is becoming easier. Patients can now access naloxone without a prescription from any pharmacy in Washington State due to the establishment of a standing order by the State Health Officer Kathy Lofy as of 8/28/19 that increases patient medication access to this life saving medication.
This standing order is considered a naloxone prescription for an eligible person or entity. This order authorizes any person or entity in Washington to possess, store, deliver, distribute or administer naloxone. This program expands access to naloxone to help save persons at risk of experiencing an opioid overdose and also empowers others to help those at risk as well.
Opioid overdoses can happen to anyone and although the media may suggest that illicit drug use is the main cause of opioid overdoses the victims come from all backgrounds. Overdoses can happen to children, adults or the elderly population and it can happen anywhere such as in a home, hospital, or a public space. That is because opioids can be prescribed for a wide range of reasons including pain management for injuries, surgery, dental procedures, and cancer care.
In Washington State it has been reported by the Kaiser Family Foundation (KFF) that in the year 2017 the two highest age ranges with reported deaths from opioid overdose were those aged 25-34 years old (190 victims) and those aged 55+ (188 victims). As of 2017 there were 379 deaths and it has increased in 2018 to 415 deaths. Furthermore, more people die from opioid overdoses each day than from car accidents in the US with a reported 47,600 opioid related deaths in 2018 as reported by the US Department of Human and Health Services (DHHS). The opioid epidemic has been worsening since then and these figures may be higher today especially with increased use of newer synthetic opioids which is reportedly one of the recent causes for the increase in opioid related deaths.
Increased access to naloxone can save lives. Good Samaritan Laws provide protection from liability for those administering aid and also assures that those who may have possession of a controlled substance illicitly are not prosecuted when seeking help or administering aid.
Don’t think twice and try to save a life.
What are the signs of opioid overdose?
Signs of opioid overdose include:
- Respiratory failure or slow, irregular breathing
- Heartbeat is slow or has stopped
- Bluing of the skin (lips, fingertips) from poor circulation
- Small constricted pupils
- Unconsciousness
- Unresponsiveness to verbal or physical stimuli (sternal rub)
Who is at risk of opioid overdose?
- Patients starting new opioid medications
- Patients more sensitive to the effects of opioid medications
- Patients previously taking opioids that are restarting opioid medications after discontinuation
- Patients taking other medications that cause sedation such as benzodiazepines
- Illicit drug users and those who inject opioids
- Households in possession of opioids
How do you use naloxone and what happens after you administer Naloxone?
- Link on how to use naloxone from stopoverdose.org.
- Naloxone is only part of the treatment, it’s important to have the patient receive emergency medical services and get them transported to the emergency room or seen by a health care provider (EMTs/Paramedics/etc.).
- If you find someone with a suspected opioid overdose:
- Try to wake them up
- Place them in the recovery position
- Call 911 immediately
- Administer naloxone
- Naloxone can temporarily revive a patient that is undergoing an opioid overdose.
- Additional doses of Naloxone may be necessary.
- While waiting for 911 you should monitor and help stabilize the patient by placing them in the recovery position and clearing their airway. Check for responsiveness by providing verbal or physical stimulation. If necessary provide rescue breathing.
- Counsel patient on how to prevent an opioid overdose and or refer to treatment programs.
Kelley-Ross provides a wide range of naloxone products and training programs on how to safely and effectively use naloxone for opioid overdose. Naloxone comes in many different forms. It can be administered through intranasal routes or through injection (subcutaneous, intramuscular, intravenous) routes. Kelley-Ross is a leading innovator in expanding access to take-home naloxone kits and carries injections and nasal sprays for the public.
With this new change it will be easier to get naloxone opioid reversal kits at Pharmacies like Kelly-Ross.
Attached below are helpful links related to naloxone from the Kelley-Ross webpage.
https://www.kelley-ross.com/naloxone-program/
WA State Naloxone Training Video
Kelley-Ross CEO Ryan Oftebro and Our Naloxone Program
Community Health Worker Demonstration – Prevent an Overdose, Save a Life
Doctor Teaching Patients
Naloxone Training Video – Narcan Nasal Spray
Naloxone Training Video Intranasal Naloxone
Naloxone Training Video Injectable Naloxone
Prepared by Richard Lee PharmD Candidate 2020
References
- https://www.doh.wa.gov/YouandYourFamily/DrugUserHealth/OverdoseandNaloxone
- https://www.doh.wa.gov/Portals/1/Documents/Pubs/690327.pdf
- https://apps.leg.wa.gov/rcw/default.aspx?cite=69.50.315
- https://www.doh.wa.gov/Portals/1/Documents/Pubs/150-127-StatewideStandingOrderToDispenseNaloxone.pdf
- https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-age-group/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
- https://www.who.int/substance_abuse/information-sheet/en/
- https://www.acmt.net/HomeNaloxone.html#Q3
- https://cpr-test.org/how-to-put-someone-into-the-recovery-position/
- https://www.cdc.gov/drugoverdose/pdf/patients/Preventing-an-Opioid-Overdose-Tip-Card-a.pdf
- http://www.stopoverdose.org/docs/Naloxone_PRO_brochure.pdf
