Overdose antidote added to county opioid outreach team

Naloxone, an antidote for opioid overdoses, will soon be included in more emergency kits in Island County.

The county’s opioid outreach team will have 100 naloxone kits available for crisis intervention, courtesy of a $7,500 grant just received from Amerigroup Washington, an Apple Health insurance provider.

Island County commissioners approved the offer during a recent board meeting.

“I am very glad we could secure outside funding for this important tool,” said Commissioner Helen Price Johnson.

The team consists of a public health nurse, outreach worker and sheriff deputies. They work collaboratively to encourage people who are abusing opioids, such as heroin and painkillers, to seek addiction treatment.

“The kits will be given to any opioid outreach clients who are at risk of an opioid overdose, or any Island County resident who may witness an opioid overdose, such as a family member of someone who is addicted,” said Skye Newkirk, behavioral health specialist with Island County Human Services.

The team is trained to use the nasal spray form of naloxone called Narcan. Learning CPR, or rescue breathing, is part of the training because most overdose victims require it to restart their breathing.

Narcan is the only intra-nasal spray approved by the FDA for emergency use for opioid overdoses. It’s viewed as a temporary lifesaving tool to be used until emergency medical response arrives.

Narcan works by attaching to the same brain receptors as opioids, but more strongly. An overdose can suppress a person’s breathing and, if untreated, can lead to cardiac arrest.

Victims may also wake up with extreme withdrawal symptoms, be combative or relapse into unconsciousness, which are also covered in training in the use of Narcan.

Nationally, opioid overdoses have quadrupled since 1999, according to the Centers for Disease Control and Prevention. Washington is among 19 states the CDC identified as experiencing significant increases in drug overdose rates from 2014 to 2015.

It’s a myth that making an antidote available to addicts encourages abuse, Newkirk said.

“Research shows that naloxone distribution and overdose education does not increase drug use, and sometimes even reduces it,” he said.

“You can’t help people if they’re dead.”

WhidbeyHealth EMS has had naloxone on hand for decades. The Langley Police Department started carrying Narcan in February specifically to combat the rise of abuse of heroin and prescription painkillers on South Whidbey.

“We’re prepared to use it but we haven’t had to use it,” Langley Police Chief David Marks said recently. “It’s a very good thing we haven’t had to use it. It’s been a little while since we had an overdose call.”

Dr. Brad Thomas, county health officer, said it’s a good idea for every first responder to carry Narcan. He also advises that people prescribed an opioid painkiller should have the antidote on hand in case of accidental overdosing.

“It’s not just people trying to get high,” he said. “It may be totally accidental. You’re drowsy, you’re in pain, you may forget how many pills you’ve taken.”

But Thomas cautioned that reversing an opioid overdose requires more than just a squirt of Narcan up a person’s nose.

“Everyone kind of forgets the CPR aspect,” he said. “CPR has to be part of the response. And calling 9-1-1.”

When a person ingests too much of an opiate drug, euphoria leads to suppressed breathing, Thomas explained.

“That’s how opioids kill you,” he said. “They just make you feel so comfortable, you don’t breathe. “

“Too much carbon dioxide builds up in your system. Their heart is still pumping but they’re unconscious. Once you give them the Narcan, you’ve got to get them breathing.”

It only takes three to five minutes of oxygen deprivation to cause permanent brain damage.

More pharmacies are offering Narcan without a prescription — but with a brief consultation — as a public health tool.

Most recently, the national headquarters of Safeway announced its following Walgreen’s lead to provide naloxone as “a lifesaving medication.”

Several laws in Washington state allow individuals to possess and administer naloxone with immunity from liability when assisting in an overdose.

A prescription isn’t needed to purchase Narcan in the state of Washington, explained Teresa Avery, a pharmacist at Island Drug locations in Clinton and Oak Harbor.

“Anyone in the state of Washington is allowed to possess, obtain and administer Narcan,” she said. “This includes getting it and administering it to someone else, such as a family member or friend.”

It’s one of 39 states allowing pharmacists and physicians to have a Collaborative Drug Therapy Agreement, making Narcan available without a prescription.

“We can bill your insurance plan and most commercial plans cover it for a standard copay,” she said.

Medicaid, the government health insurance plan for low-income families, covers the cost of Narcan, Avery said.

The cost without insurance is around $125 to $130 for two sprays.