Ind. county makes naloxone supply accessible to public
Prescriptions are no longer needed for the medicine, which can be found at local pharmacies
By Abby Tonsing
BLOOMINGTON COUNTY, Ind. — Even with the rise in opioid overdoses over the past several weeks, supplies of the overdose reversal medication, known as naloxone, are not depleted within Monroe County. In fact, there is a push to make the medicine more accessible.
As of July 1, the Indiana State Department of Health released a mandate making it easier for naloxone to be readily available not only for emergency responders, but also for the public. Prescriptions are not needed for the medicine, which can be found at local pharmacies.
County officials are also considering the idea of having the medication on hand in county government buildings, treating it similarly to an automated external defibrillator, or AED. County commissioners have asked Monroe County Health Department Administrator Penny Caudill to review the proposal and present a report on her findings with recommendations.
"The county as a whole needs to think about the availability they want for it," Caudill said Friday. "I think, at a minimum, there needs to be system in place, looking at where and what staff are most likely to encounter people who overdose."
The Bloomington Police Department, Monroe County Sheriff's Office, Indiana State Police and Bloomington Fire Department all have naloxone on hand for when a member of the public shows signs of an opioid overdose.
"At this time, we have it," said BPD Lt. John Kovach. "And our officers are free to use it as they see fit."
According to Bloomington police, if their supplies are running low, it is not difficult to receive more. They call the Monroe County Health Department to replenish the supply if needed. Having the medicine is just part of the job now, police said, and it is passed out during roll call.
"Since we've started using it, I've not heard that it's a big problem," BPD Capt. Steve Kellams said when asked about availability of the medicine.
If other emergency responders are ever running low on naloxone, there are no rules that restrict sharing among departments. Naloxone is typically administered as a nasal spray, and that method is used by all local law enforcement personnel.
A seemingly low supply of naloxone and reports of officers harmed due to fentanyl exposure led Sheriff Brad Swain earlier this week to change his policy on administering the medicine. He informed his deputies in an email Monday night to temporarily hold off on using the drug on emergency medical services calls and to keep what they had for themselves. By 2 p.m. Tuesday, the deputies' stock was replenished when 100 naloxone kits were picked up from the county health department. The deputies now have two kits on hand at all times.
The BPD and the sheriff's office receive their stocks of naloxone from the county health department, which received 500 doses to dispense beginning in December 2016. The medicine is covered with a state grant.
"We have given the Bloomington Police Department, the sheriff's department, doses, and we have also distributed doses to some social service agencies like Positive Link, Centerstone and our public health clinic," Caudill told the Monroe County commissioners on Wednesday.
During that meeting, Caudill raised concerns that training is necessary when it comes to administering naloxone, which must be addressed if the county's proposal of having the drug available at county buildings moves forward.
Indiana State Police troopers from the Bloomington post carry one to three doses on hand and also have a reserve supply of 10 doses. The money to equip ISP officers with the medicine does not come from a grant or the state mandate, but rather the ISP's operating budget.
Bloomington firefighters are also trained emergency medical services providers and carry naloxone. They receive their stock from ambulance services, which receive it from hospitals, which receive it from the Indiana Recovery Alliance through a grant from the state attorney general's office.
Often, more than one dose is needed to revive a patient. One cannot overdose on naloxone, nor is there a harmful effect if administered to someone with no opioids present in their system.
"We keep 25 kits total (1 dose per kit) and three per apparatus," Bloomington Fire Department Battalion Chief Tania Daffron said. "I keep some here at the office in the event that it is a hairy scene, and they can come by and keep that number up. If they get below the 25 total, they restock."
The fire department also has kits with yellow isolation gowns and gloves to further protect firefighters' skin in the event of potential fentanyl exposure.
"It is not something (putting on isolation gowns) we routinely do," Daffron said. "We always have gloves on, but we are taking care of the patient."
The goal of the Indiana State Department of Health mandate is to provide education and training regarding overdose reversal medication and to make it accessible through sites such as pharmacies, government buildings and local social service agencies. Those seeking naloxone can visit www.optIN.in.gov to find an registered entity.
In Monroe County, 17 entities are mapped where naloxone is available. Each is required to provide education and training on drug overdose response, treatment and administration of the drug, according to the mandate. And each time naloxone is administered, 911 must be called and notified.
Members of the public do not need a prescription to obtain the medicine at pharmacies, and training generally takes 5 to 10 minutes. At CVS Pharmacy, the drug can be covered under insurance plans, but the general cost is around $45 dollars for one dose of the nasal version.
Cost of naloxone per department:
- Bloomington Fire Department: $50 for medication and delivery service.
- Monroe County Health Department supplying Bloomington Police Department and Monroe County Sheriff's Office: $28 for the injectable dose, $37.50 for nasal mist dose.
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