A new program will be launched in Stark County — funded with a two-year state grant — that distributes a drug capable of bringing heroin users back from the brink of death when overdosing.
A local group — including representatives of the Mental Health and Recovery Services Board of Stark County — will be implementing the $48,000 grant from the Ohio Department of Health. The effort is part of Project DAWN (Deaths Avoided with Naloxone), which was launched in Scioto County, where the opiate problem was so severe it received national attention.
Narcan — Naloxone Hydrochloride — is not new to the medical world. The drug dates back decades and has been used in some local emergency rooms as far back as the mid-70s.
But the use of Narcan has expanded as the opiate epidemic — fueled by the prevalence of heroin — has grown, particularly in Ohio, Kentucky and Florida, said Jackie Pollard, director of clinical services for the Mental Health and Recovery Services Board.
The local group tentatively plans to begin making Narcan kits available at no cost starting in January through the Crisis Intervention and Recovery Center and Quest Recovery and Prevention Services in Canton.
Policies and processes must be put in place first, Pollard said.
"That sense of urgency is tremendous and the capacity to treat (opiate addicts) is difficult," said Keith Hochadel, CEO of Quest.
The seed money will not exclusively fund Narcan units. A total of 200 units — about $35 a piece — will be purchased. Other expenses include the time of the two doctors involved who will prescribe the medication. There are also some administrative expenses and other costs associated with the program, including educational materials and TVs to show a video on the subject.
Pollard, citing medical regulations, said that Narcan only can be prescribed to an opiate user. In other words, a mother cannot pick up the drug for their child who is addicted to opiates, she said. She would have to be accompanied by the son or daughter.
PART OF A STRATEGY
Narcan is not to be used as a treatment for opiate addiction, Pollard said. John Aller, executive director of the Mental Health and Recovery Services Board, said Narcan is part of an overall strategy to address the problem in Stark County.
"This is not the total answer," he said. "But this is the tool in the toolbox."
"It just sort of enhances the overall strategy for our community," Aller said.
Many cases will still require detox and treatment, Aller said. The idea is not for heroin users to overdose, use Narcan and then binge on opiates again, Aller said. They hope it will lead to treatment, he said.
Page 2 of 4 - "It makes them think differently because they almost died," said Dr. John Andreozzi, of the Crisis Intervention and Recovery Center and Summa Health System in Akron.
He said that "there's no evidence to show that dispersing Narcan makes the person more likely to use, but there's evidence that people who are given Narcan (after overdosing) ... go into treatment."
Education and training are also part of the local Narcan program. Those who pick a Narcan kit — prescribed by a doctor at one of the two sites — also will watch the video about the drug as well as learn of treatment options.
Narcan cannot be self-administered. "Literally, you need to train people around you how to use (Narcan)," Pollard said of opiate users.
'TWO SCHOOLS OF THOUGHT'
Aller said that Narcan is not immune to criticism.
"The two schools of thought are, 'This is great, this is going to save somebody's life,'" he said. "And the other school of thought is why help (a drug addict) — shouldn't we have natural consequences?"
Bernard Jesiolowski, executive director of the Crisis Intervention and Recovery Center, said the debate over whether to help addicts is faulty.
Aller concurred, adding: "We would never say (to someone with diabetes), well, you've eaten too much sugar — let's ride it out and see what happens to you."
"There's no doubt that if you had (a loved one) who overdosed on heroin, and Narcan was available, you wouldn't be thinking it's your fault if you have an addiction," Jesiolowski said.
Pollard said that mental health providers still battle a stereotype linked to heroin — that its users are criminals and junkies immersed in the street life.
Many times those who are legitimately prescribed pain medication such as OxyContin — for a back problem, broken bones, recovery from surgery and other reasons — end up addicted once they are cut off from the drug. Then they turn to heroin, which has become cheaper and increasingly available in recent years, Pollard said.
That path leads to addicts in all walks of life — suburbia, the affluent, business professionals and others, Pollard said.
The time window to administer Narcan is small, said Amanda Archer, forensic coordinator of the Stark County coroner's office. Narcan has been found in the system of those who have died from overdoses, she said.
Pollard and Archer will serve as the directors of the local unit of Project DAWN. Andreozzi and another doctor, Joseph Vrabel of Quest, will administer and monitor program.
A Narcan kit contains two doses — a second dose can be administered about five minutes after the first if the person doesn't respond, said Andreozzi. 911 also must be called — it's critical for the person to go to a hospital, he said, noting that Narcan is "short acting."
Page 3 of 4 - The medication will produce withdrawal symptoms for a person dependent on opioids. Withdrawal, although uncomfortable, is not life-threatening, according to Project DAWN.
Withdrawal symptoms can last months, Hochadel said. "The physical withdrawal is the worst flu you've ever had," he said.
And the drug does not raise someone from the dead. The person can be unconscious or passed out, but not dead, Archer said.
Pollard summed up the effects of the medication: "The Narcan just literally keeps people from dying at this particular moment."
DRUG OVERDOSE DEATHS IN STARK COUNTY
2013 42 (through Oct. 5)
2013 18 (through Oct. 5)
Source: Stark County Coroner’s Office
WHAT IS NARCAN?
The full name of the drug is Naloxone Hydrochloride. The medication has been used by emergency medical professionals for more than 40 years and has only one function: To reverse the effects of opioids on the brain and the respiratory system in order to prevent death.
When administered during an overdose, Naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes.
Naloxone does not reverse overdoses that are caused by non-opioid drugs, such as cocaine, benzodiazepines, methamphetamines or alcohol.
It is impossible to overdose on Naloxone. If the drug is given to a person who is not overdosing on opiates, it is harmless.
The only time the drug should not be administered is in patients who are known to be hypersensitive to the medication.
The drug can be administered by injection or through nasal passages.
Source: Project DAWN
WHAT ARE COMMON OPIOIDS?
Opioids include both heroin and prescription pain medications. Some common opioid medications are Lorcet, Vicodin, Percocet, OxyContin, Methadone and Fentany.
WHAT IS PROJECT DAWN?
In an attempt to stem the state’s dramatic increase in drug overdose deaths, the Ohio Department of Health, Violence and Injury Prevention Program, allocated seed money and technical assistance to initiate Project DAWN (Deaths Avoided with Naloxone), Ohio’s first Overdose Reversal Project.
Established about two years ago, Project DAWN is housed at the Portsmouth City Health Department and serves all of Scioto County.
The state health department has also provided technical assistance and additional resources to expand the program to Cuyahoga and Montgomery counties.
Page 4 of 4 - A Stark County unit of Project DAWN plans to launch a Narcan program in January with a two-year state grant.
The Mental Health and Recovery Services Board recently received a two-year $48,000 grant to establish a Narcan program. The program is scheduled to start in January — Narcan kits will be distributed at the Crisis Intervention and Recovery Center and Quest Recovery and Prevention Services in Canton.
Source: Ohio Department of Health
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