By: Marcus J. Hopkins, Blogger
The HEAL Blog has been following the issue of opioid addiction very closely, largely because Injection Drug Users (IDUs) represent a large proportion of new Hepatitis C (HCV) infections in the U.S., particularly in rural parts of the country. The Appalachian Mountain region serves as a prime example of how heroin and opioid addiction can lead to a rash of both HIV and HCV outbreaks; it also serves as excellent proving grounds for how Harm Reduction methods can help to prevent mass outbreaks, as well as save lives.
Harm Reductions measures are those that focus on preventive measures that have been shown to lessen the risk to individuals through various legal means. As they relate to opioid addiction, one of the most important measures is increased access to Naloxone, a medication that is used to block the effects of opioid drugs, such as slowed breathing and loss of consciousness. Naloxone – sold under the brand name, Narcan – is a nasal spray that is used to counteract the effects of an opioid overdose. It is currently listed on the World Health Organization’s “List of Essential Medicines,” the most important medications needed in a basic health system, and increasing ease of access without a prescription is something for which advocates have long fought.
Last week, in the city of Huntington, WV, 26 people overdosed on opioid drugs in a period of only four hours from a particularly potent batch of heroin. Of those 26 overdose cases, none of the patients died, as first responders and hospitals were quick to react, delivering a total of 12 doses of Naloxone, including the two used by Huntington police. One patient had to be revived using three doses (Struck, 2016). The remaining patients were revived using bag valve masks, a handheld device used to provide ventilation to patients who aren’t breathing. The users who overdosed ranged in age from 20 to 59, demonstrating that the opioid epidemic affects people of virtually every age range. In Cabell County, where Huntington is located, there were 440 overdoses by June of this year, 26 of which resulted in death; the state of West Virginia, itself, ranks highest in the number of overdose deaths in the U.S.
In Kentucky, the next state over and less than fifteen miles from Huntington, Kroger grocery store locations with pharmacies on site began offering Naloxone over the counter without a prescription at 96 locations, including 80 pharmacies in the Louisville Division (Warren, 2016). Kentucky currently ranks in the top five states for overdose deaths, which makes it an excellent test market for the efficacy of offering Naloxone without a prescription. That said, the Kroger locations in Ashland, KY – the city nearest Huntington, WV – does not yet offer the drug over the counter.
When we discuss expanding Naloxone access, there are a number of ways that access can be broadened – (1.) Naloxone can be carried by first responders; (2.) Naloxone can be carried also by state employees (such as school officials); (3.) Naloxone can be sold without a prescription to anyone. WV does not currently allow the sale of Naloxone without a prescription, although WV HB 4035 seeks to do just that. Access to first responders, including police and other emergency personnel, was expanded beyond just Emergency Medical Technicians (EMTs) in May of this year, but it is unclear, yet, whether or not HB 4035 will be ratified and made into law by the end of this year. In an election year, particularly in the latter half, little of substance seems to get done.
What is important, however, is that we continue to fight to expand access to this lifesaving drug. Politics and personal peccadillos aside, saving someone’s life should never fall prey to moralizing of whether or not opioid abuse is wrong, nor should saving a life be predicated upon whether or not one agrees with the lifestyle choices of the victim. When lives are at risk, every reasonable action should be taken to ensure that those lives are saved.
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.