NC county: If overdose patient refuses transport, paramedics can leave Narcan

In June, North Carolina became the third state to allow pharmacists to sell naloxone without a prescription

By Kate Elizabeth Queram
News & Record

GREENSBORO, N.C. — Two weeks ago, High Point police officers arrived at a house to find a man lying unconscious on the ground after overdosing on heroin.

It was his second overdose in two days.

Paramedics were able to revive him using Narcan, a prescription medication administered through a syringe that almost instantly reverses the effects of an opioid overdose.

Once conscious, the man allowed paramedics to take him to a hospital for treatment. But if he had refused, the first responders would have left him with an extra Narcan kit as a precautionary measure, part of a new partnership between Guilford County Emergency Services and the nonprofit North Carolina Harm Reduction Coalition.

“We have to put this antidote into the hands of those most likely to be able to use it,” said Jim Albright, the director of Guilford County Emergency Services. “We want these folks to seek treatment for their drug addiction. And we simply cannot do that with dead drug addicts.”

Narcan, also known as naloxone, is a medication that blocks the effects of opioids on the central nervous system, effectively reversing an overdose. It cannot be used to get high, and if given to a person who hasn’t taken opioids, it won’t have any effect.

The drug has only recently become available to the general public in response to huge spikes in opioid use across the country, including the Triad. North Carolina recorded 913 deaths from opioid overdose in 2014, the 10th highest number in the country, according to the N.C. Department of Public Health. Forty-two of those were in Guilford County.

From Aug. 1, 2013, to Feb. 1, 2016, Greensboro had 352 cases where naloxone reversed a potential opioid overdose, according to state data. High Point had 202, followed by Winston-Salem at 92; Thomasville, 31; and Asheboro, 24.

In June, North Carolina became the third state in the country to establish a standing order that allows pharmacists to give naloxone to people without a doctor’s prescription. The law, signed by Gov. Pat McCrory in Greensboro, also allows access to the drug for people who know someone — a friend or family member — at risk of an overdose.

The partnership between Guilford County and North Carolina Harm Reduction Coalition takes that idea one step further by furnishing ambulances with naloxone kits and allowing paramedics to distribute them directly to high-risk drug users.

The county is the first to partner with the statewide nonprofit, which offers resources and services for people affected by drug use.

The naloxone kits — plastic-wrapped syringes containing a dose of the drug, instructions and resources for substance-abuse help — are given only to people exhibiting symptoms of opioid overdose who require treatment from paramedics but refuse to be taken to a hospital once the risk of death has passed.

“If they refuse transport — and they are entitled to do that — we hand them a kit,” Albright said.

Last month, North Carolina Harm Reduction Coalition furnished the county with an initial order of 100 kits, enough for two in each ambulance. Since then, paramedics have administered the drug 56 times, according to county data.

Each kit costs the nonprofit about $10 and is provided to the county at no cost, said Tessie Castillo, the nonprofit’s advocacy and communications coordinator.

“When an overdose happens, we know that person is at risk of another overdose and EMS gets to those people first,” she said. “It just makes sense.”

Research has shown that increasing the use of naloxone in a community can reduce overdose deaths by as much as 50 percent, giving advocates more chances to reach people affected by substance abuse, which is the ultimate goal, Castillo said.

“We have seen people come back after (overdose) reversals who have gone into treatment. We’ve also seen some people who haven’t,” she said. “But the point is that they have the opportunity to make that choice.”

Copyright 2016 the News & Record

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