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In opioid epidemic, supplying life-saving antidote ‘last best option’

Through October of this year, Jefferson County Health Department supplied nearly 4,700 naloxone kits to Alabama residents who requested them.

Naloxone, also called Narcan, is a nasal spray that counters the deadly effects of opioid overdose. 

State agencies’ efforts to reduce drug overdose deaths is multifaceted: reducing the stigma around drug addiction, making treatment more available to those who want it, and raising awareness about the dangers of opioids, particularly fentanyl, while trying to stem its flow into the state.

But when those efforts aren’t enough, officials say naloxone can save lives.

“It’s your last best option,” State Health Officer Dr. Scott Harris told Alabama Daily News. “It doesn’t treat or address anyone’s substance use disorder or the reasons they may have suffered an opioid overdose, intentional or unintentional, but it saves lives.”

Naloxone requires a prescription, but in 2016, state lawmakers approved legislation allowing the state health officer or county health officers to issue standing orders for dispensing opioid antagonists. That order serves as a prescription. 

In late 2020, Jefferson County Health Department began sending naloxone kits to people statewide if they watched an eight-minute video on how to recognize an opioid overdose and how to administer the spray. Naloxone doesn’t harm if administered to someone who hasn’t taken an opioid. The department also provides fentanyl test strips, which lawmakers legalized earlier this year. Dr. Darlene Traffanstedt, the department’s medical director, in October said there has been a 233% increase in fentanyl-related overdose deaths in Jefferson County over the past two years.

According to the Centers of Disease Control and Prevention, there were 1,321 drug overdose deaths in Alabama in the 12-month period that ended in May 2022. Three years earlier, there were 750.

As few as two milligrams of fentanyl can be deadly, depending on a person’s size, according to the U.S. Drug Enforcement Agency. And because sellers use fentanyl to make other drugs like cocaine, heroine and counterfeit prescription pills more potent and addictive, users may not know they’re receiving fentanyl.

Traffanstedt said the hope behind the kit distribution is to save lives until people are ready for treatment. Meanwhile, recovery services need to be increased so that when people want help they can get it regardless of their ability to pay or their insurance status. According to information presented to the state’s opioid task force in November, 54% of Alabamians live in counties without opioid treatment programs.

While kits mailed to Jefferson County residents are paid for by the county department, the Alabama Department of Mental Health is funding those sent to people in other counties. The department has also helped get kits to law enforcement, first responder agencies and schools.

“We know Naloxone won’t make the opioid epidemic go away, but it saves those people who are still struggling and trying to get into recovery,” said Nicole Walden, association commissioner of the Alabama Department of Mental Health.

She said one of the goals, after Naloxone is administered, is to connect people with peers who have been in recovery for a few years.

“They can help give that person someone to talk to and it gives that peer a chance to say, let’s go to treatment so this doesn’t happen again,” Walden said.

Traffanstedt said the department wants to get Naloxone kits to drug users who are at high risk for an overdose “and those who surround them.”

Because the nasal spray is easy to administer, Traffanstedt hopes people will be willing to help those in an overdose situation.

“I want people to begin to think of it like they would think of an (automated external defibrillator),” Traffanstedt said. “If you would be willing to grab an AED that was stored in a public place and use it on an individual who’s down from a cardiac arrest, we would love to see people being as willing to try Naloxone for someone who may be down from an overdose.” 

 

How to get Naloxone:

To see the Jefferson County Health Department’s online Naloxone training video and order a kit, visit https://www.jcdh.org/SitePages/Programs-Services/CommunityHealth/SubstanceUseandAddiction/NaloxoneFentanylTraining.aspx.

 

Separate from distribution to the public, the kits are now being supplied to law enforcement agencies, first responders and schools.

“Especially on high school and college campuses right now, we’re seeing an influx of counterfeit pills that look like legitimate prescription medications but they’re contaminated with fentanyl,” Traffanstedt said. “So, young people who think they’re taking a safe prescription medication are at risk of an accidental overdose if they get one of these counterfeit pills. And that is something new in the last couple of years and changed the face of the overdose crisis and driven the age down.”

At the University of Alabama, training and kit distribution to some student groups, including fraternities and sororities, has begun.

John McClendon, a University of Alabama junior and member of the Student Government Association, last year helped initiate what is now a multi-group effort to raise awareness on campus. McClendon told Alabama Daily News the effort started after discussions with friends from home in suburban Atlanta about overdoses at other colleges and among their friend groups.

“I think (the opioid epidemic) has gotten worse since my freshman year and that’s really unfortunate” McClendon said. “But I think we’re trying to do the right things now to try to prevent it. We’re doing everything we can.”

Walden said information about who requests is kept private and not shared with other agencies. When the kits are used, people can request another.

“I do think this saves lives,” Walden said. “I think you can’t help people who are dead and this gives us a chance to save lives.”

How to get help:

Call 1-844-307-1760 if you, a friend, or a family member needs information regarding addiction treatment.

Connect Alabama, a behavioral health services and treatment finder application, provides individuals instant access to education, information and services related to substance use, mental health, and prevention.

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