Narcan offers immediate life-savings, opportunity to engage addicts long-term

L to R: Sarah Wakeman MD, Jeffrey Baxter MD, Ruth Potee MD, and DPH Commissioner Monica Bharel, MD.

By Debra Beaulieu-Volk, Vital Signs Staff Writer

“We need to keep patients alive long enough to treat them,” Sarah Wakeman, MD, of Massachusetts General Hospital, told attendees of the MMS’ Opioid Misuse and Addiction Summit held last Friday.

A key tool in the state’s arsenal to make addiction recovery possible, experts agreed, is the overdose-reversal drug naloxone, better known by its brand name Narcan. Timely administration of the drug is credited with saving 5 million lives throughout the Commonwealth, according to Monica Bharel, MD, Massachusetts’ Public Health Commissioner.

Although treating acute respiratory emergencies due to overdose is just one piece of the opioid epidemic puzzle, it allows “an opportunity to engage a person who is battling the disease of addiction,” Bharel said.

According to expert panelists, positive steps toward optimizing this opportunity in Massachusetts include the following:

  • The creation of standard orders to make naloxone available at pharmacies without a prescription, not just for patients using opioids but also to secondary individuals such as patients’ family and friends.
  • Distributing naloxone toolkits as standard equipment on law enforcement toolkits. Massachusetts has been a groundbreaking leader on this front, said U.S. Attorney Loretta Lynch. “They can’t always be there [to respond to an overdose], but we can take steps to ensure law enforcement is prepared,” she said.
  • Maintaining reasonable cost to supply and replenish supplies of the drug to first responders and hospitals. “We never want cost to be a barrier to somebody’s ability to access lifesaving medication like that,” stated Maura Healey, Massachusetts Attorney General.
  • Ensuring people carrying Narcan, in either injectable or nasal form, receive proper training. Ideally, at-risk patients or caregivers would receive initial administration instructions in the physician office where the drug is prescribed, followed up with training by a pharmacist filling the prescription, provided that a private consultation area is available, experts said.

Although many overdoses occur when victims are alone, having medication such as Naloxone available is similar to keeping a fire extinguisher in one’s home, said Samuel Penta, RPh, senior investigator with the MA Board of Registration in Pharmacy. “You may never need it, but it will be there if you do,” he said.

Of course, immediate lifesaving doesn’t ensure a person’s long-term freedom from addiction. But use of modalities including medically assisted treatment, behavioral therapy, and other resources can begin as early as a trip to the emergency room, physician experts said.

“This puts the onus on the healthcare system,” Wakeman said. “We don’t have to wait for people to hit bottom. We have treatments that work and need to stat them as soon as possible.”

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