Heroin in the Valley: Access to antidote
Narcan widely available locally when overdoses happen
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By Janelle Patterson
The Marietta Times
jpatterson@mariettatimes.com
Within the past year, pharmacies across Ohio have begun stocking a second chance behind the counter for those who could overdose from opioids.
That life-saver is called Naloxone, and it's marked a rare step of making antidotes to illegal drugs widely available, a sign of just how serious the heroin epidemic has become.
"Most people who are requesting the third-party prescription are looking to have it on hand to save the life of a friend or loved one who they believe, or have seen, has an addiction to heroin or prescription opiates," said Kroger Patient Care Coordinator Shannon Gooden. "Many insurances are covering it now, and there are a few different administration forms so if your insurance doesn't cover one, it may cover the generic brand or a smaller dosage."
Ten pharmacies in Washington County will provide Naloxone without a doctor's prescription at a cost around $120.
According to the Ohio Department of Health, Naloxone (also known in some forms as Narcan or Evzio) is a medication that can reverse an overdose caused by an opioid drug such as heroin or prescription pain medications. When administered during an overdose, Naloxone blocks the effects of opioids on the brain and quickly restores breathing.
"But a dose of Naloxone doesn't guarantee that your overdose is done, so we are adamant in training with the person requesting it that they must still call 911," said Gooden. "Another risk is that a large enough dose of Naloxone will cause a person addicted to opioids to go into withdrawal and become combative."
Though state officials say Naloxone has no potential for abuse, Marietta City Fire Chief C.W. Durham said a home stock of Naloxone should not take the place of calling in emergency personnel in the event of an overdose.
"It's a good tool to have out there but only as long as it is used correctly," he said. "We don't want people to use it and then think they shouldn't also call us because the heroin or other opioid could be longer lasting that the short-term Naloxone and they could fall back into overdose."
Durham said that though his squads have not yet come upon an overdose where a loved one has administered the home-use dosage, if that were to occur the emergency staff would still have additional Naloxone on hand in the case of a resurgence of overdose.
"There are no adverse health effects of the drug, even if the overdose isn't related to an opioid," he explained. "It's a blocker that only acts on one receptor in a specific location."
Drew Massey, head of clinical services for Fruth Pharmacies, said Naloxone can be seen as the heroin response equivalent to a defibrillator.
"It's a scary moment to find someone overdosing in a bathroom stall or a car," said Massey. "And we're seeing more and more that people who want to use and are going to use alone are often going to a public place so that if they overdose, that the likelihood of revival is better."
Massey explained that state regulations dictate that counseling about Naloxone use isn't optional if an individual wants to take home the medication.
"Correct use and storage are just as important for the person getting it to know, as it is to provide connections to care," he explained. "All our pharmacists are trained to help family members of an addict by directing them to help services."
While pharmacies provide differing forms of Naloxone at a cost either directly to their customer or the person's insurance, the life-saving drug is also available for free through the state program, Project DAWN.
DAWN, or Deaths Avoided with Naloxone, is a community-based overdose education and Naloxone distribution program that provides free training through specific program sites for recognizing the signs and symptoms of overdose, distinguishing between different types of overdose, performing rescue breathing, calling emergency medical services and administering intranasal Naloxone.
The program is grant-funded through the Ohio Department of Health and provides training to both first-responders and at some locations to the public.
The Washington County Health Department has the program's kits on-hand at its Marietta office to train and send home for free to both parties, but Morgan and Noble county health departments only have enough to supply free kits to first responders.
"We were lucky enough to get grant funds to provide it for our first responders but the public hasn't shown much interest," said Beth Caine, director of nursing at Morgan County's health department. "Out of the nine kits we had available two have gone to our schools and I still have some on hand for people to come in and be trained to use it."
She also explained that while the preemptive acquisition of Naloxone is fairly new, it is not unlike the forward-thinking prescription of an Epi-Pen for those with severe allergies.
"This epidemic didn't happen overnight," said Caine. "But we need to be ready for the emergency when it happens. I think our sheriff and others in the area are starting to face the problem and really try to get ahead of it so that we can try to not lose so many lives."
She said the cost of the program's kits are $72.50, which is paid for through donations to the department, and the kit contains two doses, two nasal atomizers and two face masks. She also said each kit has a one-year shelf life.
Caine said her training consists of putting together the different pieces of the Naloxone conduit and that she may be reached at 740-962-4572 for an appointment. Likewise Washington County public and first responders may make an appointment with the county's Director of Nursing Valerie Betkoski by calling 740-374-2782.
Project DAWN is also the source of local first-responders kits used in emergency situations. Washington County Sheriff's Deputy David Tornes said he keeps Naloxone kits in stock in the sheriff's evidence locker. They're on hand in case a deputy comes into contact with topical doses of Carfentanil, a newer synthetic drug with which just a few granules of contact could be enough to be lethal.
Where to get it
Washington County pharmacies that distribute Naloxone without a doctor's prescription:
¯ CVS, 1013 Washington Blvd., Belpre.
¯ CVS, 131 Third St., Marietta.
¯ Fruth Pharmacy, 1401 Washington Blvd., Belpre.
¯ Giant Eagle Pharmacy, 128 Gross St. in the Frontier Shopping Center, Marietta.
¯ Kroger Pharmacy, 40 Acme St., Marietta
¯ Kroger Pharmacy, 1008 Washington Blvd., Belpre.
¯ White Oak Pharmacy, 8465 State Route 339, Vincent.
¯ Rite Aid, 201 Washington Blvd., Belpre.
¯ Rite Aid, 301 Greene St., Marietta.
¯ Walgreens, 300 Greene St., Marietta.
Note: No pharmacies in Morgan, Monroe or Noble counties distribute Naloxone.
Local Project DAWN distribution sites:
¯ Washington County Health Department:
¯ 342 Muskingum Drive, Marietta.
¯ Call for an appointment for training at 740-374-2782.
¯ Morgan County Health Department:
¯ 4275 State Route 376, McConnelsville.
¯ Call for an appointment for training at 740-962-4572.
¯ Note: Morgan County only provides training and Naloxone kits for first responders.
¯ Noble County Health Department:
¯ 44069 Marietta Road, Caldwell.
¯ Call for an appointment for training at 740-732-4958.
¯ Note: Noble County only provides training and Naloxone kits for first responders.
¯ There is no site either at the Monroe County Health Department nor at a pharmacy in that county that provides Naloxone.
¯ More information on Project DAWN can be found at odh.ohio.gov/health/vipp/drug/ProjectDAWN.