Naloxone Information

Opioid Overdose Education and Naloxone Distribution (OEND)


Opioid overdose continues to be a public health concern in Oklahoma. Naloxone is used to reverse the effects of opioid overdose, and is a recommended means to save lives and reduce the overall impact of addiction. The Oklahoma Health Care Authority (OHCA) has partnered with the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) to increase access to naloxone. Funds have been received from the Health Services Initiative – Children’s Health Insurance Program (CHIP) to provide this life saving drug to at-risk youth. This Opioid Overdose and Naloxone Distribution (OEND) Program makes naloxone available, at no charge, to any individual 19 years or younger or to anyone who knows a youth who is at risk of overdose. 

ODMHSAS identified 13 high-need counties across the state in which naloxone distribution may be of benefit to the community. Select Opioid Treatment Programs (OTPs) and Comprehensive Community Recovery Centers (CCARCs) will serve as distribution hubs for naloxone. These distribution hubs have pre-established clinical structure to provide naloxone at no charge in these targeted areas.
OEND services are available at no charge to anyone 19 years of age or younger or those who know of youth at risk of overdose. As a pharmacist or health care provider, you play an important role by making this life-saving drug easily available and accessible, as well as communicating the importance of proper administration of this medication. Please direct individuals who need assistance and meet the OEND program criteria to programs listed here. For your convenience, below are selected resources for more information and a map to help locate the CCARC or OTP nearest to you.

Overdose Education and Naloxone Distribution (OEND) Sites:

Grand Lake Mental Health Center
700 S. Penn Ave.
Bartlesville, OK 74003

12&12
6333 E Skelly Dr.
Tulsa, OK 74135

Center for Therapeutic Interventions (CTI)
7477 E 46th Pl
Tulsa, OK 74145

Human Skills & Resources
2140 South Harvard
Tulsa, OK. 74114

Rightway Medical
3445 S Sheridan Rd
Tulsa, OK 74145

For other locations statewide, please contact WCWI Leadership Team.

Where to Purchase Naloxone in the Washington County, Oklahoma Area: 

  • Walgreens - 3816 E Frank Phillips Blvd., Bartlesville, OK 74006 - (918) 333–0588 - Click here for store information.

  • Popkess Pharmacy – 524 E. Don Tyler Ave, Dewey, OK 74029 (918) 534-22662

  • Boulevard Discount Pharmacy – 1117 SE Frank Phillips Blvd, Bartlesville 74003 (918) 336-2140

  • CVS Pharmacy 3711 E. Frank Phillips Blvd Bartlesville 74006 (918) 333-5217

  • Express Pharmacy 123 SE Washington Blvd. Bartlesville 74006

  • Food Pyramid Pharmacy 2501 SE Washington Blvd Bartlesville (918) 335-1133

  • Jane Phillips MedCare Pharmacy 3500 E. Frank Phillips Blvd Bartlesville 74006 (918) 331-1540

  • Limestone Pharmacy 3803 Nowata Rd Ste C, Bartlesville 74006 (918) 331-000

  • Walmart Pharmacy 400 SE Green Country Rd. Bartlesville 74006 (918) 333-6910

What Is Naloxone?

Naloxone is the antidote that reverses an opioid overdose. It works by neutralizing injested opioids and helping you breathe again. Naloxone only works if a person has opioids in their system and it is safe for nearly everyone.

Since 2015, over 70 Oklahomans are still alive because they received Naloxone.

Why We Need Naloxone:

Washington County Unintentional Poisoning Facts

  • From 2007-2015, there were 71 unintentional poisoning deaths in Washington County.

  • Washington County had the 41st highest unintentional poisoning death rate and 45th highest unintentional prescription drug overdose death rate in the state.

  • Seven out of ten unintentional poisoning deaths involved a prescription drug.

  • Six out of ten deaths involved a prescription painkiller.

  • Males were more likely to die of an unintentional poisoning than females.

  • Adults age 35-54 had the highest rate of unintentional poisoning death.

  • Nearly half of people who died of an unintentional poisoning had a history of mental health problems.

  • More than half of people who died had a history of substance abuse.

  • Two out of three deaths occurred at a home or apartment, while three in ten occurred at a hospital.

  • The most common cities of residence were Bartlesville (79%) and Dewey (13%).

Source: Injury Prevention Services: Washington County Rx 2015 Datasheet - (405) 271-3430

What is a Poisoning? 

A poisoning is the ingestion, inhalation, absorption, or contact with a substance resulting in a toxic effect or bodily harm. An unintentional poisoning occurs when a person does not intend to hurt themselves or someone else. The person may intentionally be exposed to a substance (e.g., a person ingests a medication at higher than prescribed levels) but does not intend to harm themselves.

  • In the late 1990s the most common cause of overdose deaths became prescription drugs.

  • Nearly four out of five unintentional poisoning deaths in Oklahoma involve at least one prescription drug.


Oklahoma State Facts:

  • From 2007-2015, more than 6,000 Oklahomans died of an unintentional poisoning (UP).

  • More Oklahoma adults age 25-64 die of UP than motor vehicle crashes or suicide.

  • Prescription painkillers (opioids) are the most common drugs involved in UP deaths.

  • In 2015, Oklahoma had the 19th highest poisoning death rate in the U.S.

Number of Unintentional Poisoning Deaths in Washington County by type of substance, 2007-2015

  • All unintentional poisoning - 71 deaths

  • Prescription Drugs - 50 deaths

  • Prescription Painkillers (Opioids) - 41 deaths

  • Illicit Drugs - 17 deaths

  • Alcohol - 9 deaths

Most common substances in Washington County unintentional poisoning deaths:

Hydrocodone
Methamphetamine 
Methadone 
Alcohol 
Alprazolam 
Morphine 
Oxycodone 
Diphenhydramine 
Amitriptyline 
Fentanyl

Prevention

  • Take medications as prescribed, and never more than the recommended dosage

  • Never share or sell prescription drugs

  • Properly dispose of unused, unneeded, or expired drugs

  • Keep all medication in a safe place to avoid theft

  • Call 211 for help finding treatment referrals

Signs/Symptoms of an Overdose

  • Won’t awaken when aroused

  • Bluish purple skin tones for lighter skinned people and grayish or ashen tones for darker skinned people

  • Slow, shallow, erratic, or absent breathing

  • Snore-like gurgling or choking sounds

  • Elevated body temperature

  • Vomiting

  • Irrational behavior or confusion

Emergency: Call 911 immediately if you suspect someone is overdosing

Common Generic: Brand Name Prescription Drugs

  • Alprazolam:Xanax

  • Carisoprodol:Soma

  • Cyclobenzaprine:Flexeril, Fexmid

  • Diazepam:Valium

  • Fentanyl:Duragesic Patch

  • Hydrocodone:Lortab, Norco, Vicodin

  • Methadone:Diskets, Methadose

  • Morphine:MS Contin, Kadian, Avinza

  • Oxycodone:OxyContin, Percocet, Endocet

  • Tramadol:Ultram, Rybix, Ryzolt

  • Zolpidem:Ambien, Intermezzo


Project Narcan: BPD officers equipped with life-saving rescue drug

By Kelli Williams
City of Bartlesville

 Unintentional opioid drug poisoning has reached epidemic proportions in the U.S., with thousands of Americans dying from overdose each year. Combined with methamphetamine, the drugs were to blame for 899 deaths in Oklahoma in 2016 alone, according to the Oklahoma Bureau of Narcotics. Thirteen of those deaths were in Washington County.

In an effort to help stop the death toll from climbing, all Bartlesville Police Department officers were recently issued naloxone kits — a life-saving rescue drug that voids the effects of opioid-based drugs in the body.

Better known by the brand name Narcan, the drug has proven to be safe and easy to administer, and is responsible for saving countless lives, Tulsa Police Department Officer Anthony First told BPD supervisors during a Narcan training class held earlier this month. First, a Tulsa Police Department Special Operations Team paramedic, medical support and training officer, provided the training prior to the issuance of Narcan to BPD officers.

How it works

“What Narcan does is just void out the effects of the opioid. It doesn’t ‘do’ anything else to you,” First said. “It goes into the bloodstream and voids out the opioid, which makes their breathing pick up again. And that’s what’s going to save their life.”

Opioid-based drugs include codeine, fentanyl, hydrocodone, methadone, heroin, morphine and oxycodone. According to First, growth in the use of the painkiller fentanyl has proven to be the game changer in causing the number of deaths due to opioid-based drugs to skyrocket is the U.S. — including in Oklahoma.

The drugs

“We love our pills in Oklahoma,” First said. “We’re No. 5 in the country for the number of pills that are prescribed. And of course we’ve had heroin around for a while, but heroin is (only) about 15-20 percent pure. It’s just not that good. Well, enter fentanyl. Fentanyl entered our market about two years or so ago. On the east coast and other parts of the country it’s absolutely brutal, and it’s getting that bad in Oklahoma.”

First said that while all opioid-based drugs are powerful, fentanyl is in a class by itself.

“If you imagine morphine being a ‘One,’ your oxycontins and hydrocodones are maybe about five times as powerful,” he said. “They’re not meant to be super powerful, they’re meant to just make some pain go away. Fentanyl, which is 100 percent pure, and this is what we’re seeing on the streets, is 100 times more powerful than morphine. So you can see that when folks use this, they’re going down immediately.”

The numbers: Oklahoma

First said the number of overdoses due to fentanyl is growing everywhere, prompting Oklahoma to start offering equipping law enforcement with Narcan in 2014.

“To give you some idea of how bad our overdose problem is — mainly because of fentanyl — there are parts of the country where agencies that used to have one or two a month now are now having 10 to 20 a day,” he said.

“We lose two people a day in Oklahoma (to opioid drugs). We have more people die in Oklahoma due to (opioids) than we do car crashes.”

And while many of these overdoses involve people who use the drugs illegally, they’re not the only ones, First said.

“It’s not just people who are using drugs recreationally, illegally,” he said. “It’s also kids who get in their parents’ medicine cabinets, and older folks who mix up their medications.”

The numbers: Washington County

In Washington County, more than 800 overdoses have been reported in the last four years, according to the Washington County Wellness Initiative, a local non-profit agency that has partnered with the Cherokee Nation to work toward reducing prescription drug abuse in Washington County.

According to WCWI, 71 people died from accidental overdose in Washington County between 2007 and 2015. Fifty of those involved prescription drugs and 42 involved prescription painkillers. Between 2012 and 2016, Jane Phillips Medical Center reported 830 overdoses, and 171 overdoses were reported by JPMC in 2016, according to WCWI records.

“We are seeing more deaths locally from opioid drug use,” said BPD Detective Jim Warring, who works with the WCWI on drug-related education. “We have heroin on the east coast filtering this way, and Mexican drug cartels are getting into the poppy business. These drugs are here now and are trending toward an even larger presence in the future. Unfortunately, this is a problem that is probably going to get worse before it gets better.”

Police Chief Tom Holland said the decision to issue Narcan to BPD officers was an easy one.

“The Bartlesville Police Department joins a long list of law enforcement agencies in Oklahoma that are now issuing Narcan to their officers,” Holland said. “I’m sure we all wish this wasn’t necessary, but the fact is these drugs are killing people. And if there is something the police department can do to help stop that, we are more than willing to do it.”

Statewide response

In fact, 64 percent of all law enforcement officers in Oklahoma are currently able to administer the rescue drug. According to First, Narcan has been deployed by law enforcement officers across the state 108 times since it began to be used in 2014, with 88 “reversals.” In Tulsa, Narcan has been used approximately 40 times with 34 reversals, he said.

“And that’s just law enforcement,” he said. “Many of these ‘saves’ are made by family members,” he said.

Narcan is available at most pharmacies and does not require a prescription. The cost of a Narcan kit, when purchased retail, is approximately $50. Narcan kits for Oklahoma officers and other first responders are funded and provided by the Oklahoma Department of Mental Health and Substance Abuse Services.

The problem

First acknowledges some agencies in the U.S. are having a problem paying for the amount of Narcan that is needed, citing costs in Florida, Ohio and Michigan as upwards of $200 per dose.

“And they’re using it ten to twenty times a day,” First said. “So you can see what it’s doing to their budgets. It’s so bad, at least two cities have tried to pass municipal ordinances saying that if (law enforcement) has to revive you more than two or three times, you’re done.

“Fortunately, none of those have passed,” he said.

First also addressed a sentiment in some communities of reluctance to offer Narcan because it is felt the drug “makes the problem worse.”

“I get that,” First said. “The problem is massive. It’s too big for anyone in this room to fix. But what we can affect is what’s happening right in front of us — what’s happening in the living room we’re standing in when a mom finds her kid not breathing. Or what happens when we go to a high school and find a student, maybe a kid of one of our fellow officers, not breathing.

“At the end of the day, if it was your kid, how many times would you do it? Would you have a cut-off number? If it was your mom or dad, would you get to number six and say, ‘You know what? We’re just making the problem worse. I’m not going to do it anymore.’ All these folks are someone’s kids, they’re someone’s mom, someone’s dad.

The effects

According to First, Narcan takes about 30 seconds to administer. One dose of Narcan is four milligrams, and while one dose generally revives the patient, sometimes two doses are required. (BPD officers are equipped with two doses.)

“If that doesn’t do anything whatsoever, chances are it was not opiate-based,” First said.

Drugs that can prompt a similar effect of an opioid-based overdose include alcohol, Xanax and methamphetamine. Narcan will not revive those patients, he said.

The drug is administered through the nose and “is good” for only about 60 minutes. Chest compressions may be necessary if there is no pulse, First said.

“If it’s an (opioid-based) problem, you should see them start to recover in about a minute or so,” he said. “Their breathing will improve, their skin will look a little better. They may or may not awaken, that depends on what (drugs) they’ve got in them. But they will improve and get out of that life-threatening situation within about a minute or so.”

Because the effects of Narcan wear off within an hour or so, overdose victims should receive medical care even after Narcan is given, First said. BPD officers administering Narcan will remain with the patient until medical help arrives.

Good Samaritan Law

Law enforcement officers in Oklahoma are permitted to administer the life-saving drug under the Good Samaritan Law, which, as of Nov. 1, now includes protection specific to the administration of naloxone (Narcan).

“We’re grateful to our legislators for adding this extra layer of protection for our officers,” said City of Bartlesville Administrative Services Director Mike Bailey. “We were always covered under the Good Samaritan Law, but this addition goes a little further and specifically protects law enforcement in administering naloxone, or Narcan.”

Project: Save lives

BPD Patrol Capt. Rocky Bevard said that while law enforcement will continue in their efforts to combat drug trafficking and other serious crimes, the Narcan project is purely a life-saving effort and should not be confused with drug enforcement.

“This is not an enforcement issue,” he said. “We want everyone, no matter who it is, to feel comfortable approaching a Bartlesville police officer and asking for help.”

According to First, while Narcan can save the life of a child or someone accidentally exposed to opioid drugs, it can also offer a second chance to those who use the drugs illegally.

“If we can keep that person alive long enough to get to that nine-year mark, when most people are able to get clean from an opioid-based problem, we can get them back to their families — we can get them back to their friends, to their jobs and their schools,” he said. “It’s a win-win for everyone.”

Source: CityofBartlesville.org link


BPD Officers Save Lives Using Narcan

Bartlesville Police Department Adam Shift officers are being credited with saving the lives of two local residents by applying NARCAN — a life-saving rescue drug that voids the effects of opioid-based drugs in the body — in two separate incidents occurring over the Christmas holiday weekend.

BPD officers were equipped with naloxone kits, commonly referred to as NARCAN, in October and have since used the drug twice with a life-saving effect, police officials said this week.

“Officers on Adam Shift encountered two separate incidents over the Christmas holiday weekend where overdose victims’ lives were saved through the efforts of BPD personnel,” said BPD Capt. Rocky Bevard. “In both incidents, NARCAN kits were deployed as well as other life-saving first aid provided by BPD officers.”

BPD Public Information Officer Capt. Jay Hastings said the first incident occurred on Dec. 23, 2017, when a man was reported to police to be bleeding from the wrist in the back yard of a Bartlesville residence.

Officers Cody Lemons and Tyler Lee responded, found the man and applied a tourniquet. The man, who was unconscious, began to shake "as if he were seizing," reports show. At that time Lee administered NARCAN.

“The victim regained consciousness soon after and was transported to the emergency room for treatment,” Hastings said.

The second incident occurred on Dec. 25, 2017 — Christmas Day — when officers William Lewis and Josh Newell administered two 0.4 mg. doses of NARCAN and did chest compressions on a local man who had fallen to the floor at a party.

“Officers were dispatched to a residence in Bartlesville following a report from others at the party that he had collapsed,” Hastings said. “Officers Lewis and Newell found the man lying on the concrete floor of the garage. He was not breathing and did not have a pulse, his skin was pale and he was bleeding from a head injury from where he had fallen.”

According to witnesses, the man was known to have previous issues with substance abuse.

“Officer Lewis administered the first dose of NARCAN, which had no noticeable effect, so he began to administer chest compressions,” Hastings said. “Officer Lewis heard air attempting to exit the man’s airway, but it appeared to be obstructed. The officers checked the man’s airway and realized his tongue, which was extremely swollen, was blocking the airway, so they adjusted his head and resumed the chest compressions.”

Hastings said it was during the second set of compressions that the officers felt a heartbeat and the man began to gag.

“Officer Lewis discontinued chest compressions at that time but resumed them when the man stopped breathing again,” Hastings said.

Ambulance Service personnel soon arrived and administered another dose of NARCAN, at which time the victim began to breathe normally.

“After a few minutes he was able to sit up and speak, though he was unsure what had happened to him,” Hastings said of the victim.

Hastings said the emergency room physician on duty contacted Adam Shift Lt. Rob Fouts to commend the officers for their actions.

“The doctor explained that there is absolutely no doubt that had officers Lewis and Newell not taken the actions they did, the victim would be dead,” Hastings said.

Chief of Police Tom Holland said the officers involved will officially be recognized for their acts of heroism at a later date.

“I could not be more proud of the actions of these officers,” Holland said. “The fact that people are alive and recovering is testimony to the heroism of our officers.”

Original Post Link
About Fentanyl: http://sites.utexas.edu/naloxone/fentanyl/