Ky. county plans Narcan expansion after increase in opioid OD calls

EMS Executive Director Charles Cremeans said overdoses seem to come in waves when a new batch of heroin or fentanyl hits the streets, but is seeing an increase overall


Rachel Adkins
The Daily Independent, Ashland, Ky.

ASHLAND, Ky. — Within the last six months, Boyd County Emergency Medical Services has administered 287 doses of Naloxone—a drug often referred to as Narcan that is used to temporarily reverse the effects of an opioid overdose.

EMS Executive Director Charles Cremeans said the standard for one dose is 2 milligrams entered intravenously if possible.

“But we have people that get upward 6 or 8 milligrams,” he said.

Each individual dose costs about $70, which the facility pays for with its two revenue sources including billing and a tax. Cremeans said the facility does get reimbursed, but not for the entire amount. EMS are the only first responders in Boyd County to currently administer Narcan.

Cremeans said overdoses seem to come in waves when a new batch of heroin or fentanyl hits the streets. But overall he said EMS is seeing an increase in the total number of overdoses.

“Overdoses are about 20 percent of our calls over the last six months,” he said.

Even though an individual has overdosed Cremeans noted that Narcan cannot always be used successfully. Since Narcan is intended for opioid use, it will not be as effective for individuals that mix their opioids with other substances like anti-depressants or even carfentanil, a substance that is around 100 times stronger than fentanyl.

“It’s effective when it works but if it’s the wrong mixture of drugs it has no effect at all,” he said.

Cremeans also pointed out that because of this, the 287 doses of Narcan administered doesn't truly represent the actual amount of overdoses within the county.

In Ashland the Ashland Fire Department is typically called to an overdose scene before EMS. Fire Chief Greg Ray said firefighters will establish a cleared airway with the individual and assist them with breathing until EMS arrives. Ray said the AFD ran 143 overdoses last year. This year there have been 31.

Boyd County Coroner Mark Hammond said there have been 12 overdose deaths so far this year. Last year there were 40. Greenup County Coroner Neil Wright gave an estimate of 10 overdose deaths so far this year in Greenup County.

Cremeans said it is not uncommon to encounter the same individuals multiple times on an overdose call, noting there are certain areas in Boyd County that are known for having heavy drug use.

“We may see a person that overdoses today and we may take them to the hospital and we may see them later that day overdose again or we may see them the next day,” he said.

Local health departments have recently started offering Narcan as well. Through a Kentucky Department of Public Health grant Greenup, Boyd and Carter County Health Departments have received doses of Narcan that can be administered nasally.

Greenup Health Educator Cassie Mace said the department has been offering Narcan for about three weeks to those with an addiction as well as family members and friends of those with an addiction. Mace said that as of April 23 18 kits have been given out so far with 108 kits left in stock.

“I’ve had reports back that two of them have already been used,” she said. Carter County Health Department Director Jeff Barker said the department was given 300 Narcan kits from the state back in March that are being administered through its needle exchange program. Family members and friends can pick up kits as well. During the month of March he said 45 kits were given out.

Barker said there were recently three overdoes in Carter County within the time-span of a week.

“I feel like with the drug issues that the Narcan is definitely needed in the community to potentially save some lives,” he said.

Ashland-Boyd County Health Department Director Maria Hardy said the department has not received any kits yet. She anticipates the department will be sent at least 100 to 150.

Cremeans said he hopes the act of administering Narcan through area health departments will be successful, but said he wishes there was a better way to deal with the problem, noting the individuals receiving the Narcan need treatment.

He said EMS tries to steer people toward agencies that can help them but they have to personally want to make a change. There is also a new pilot program at the facility via the Kentucky Board of EMS called the Community Paramedic Program that he feels could help those with an addiction. Under the program supervisors make contact with certain categories of patients to help individuals get the care they need to help prevent them from having to call 911 or repeatedly visit the emergency room. One of the groups targeted are drug overdose patients with the goal of getting them into a treatment program.

“If we can get them treated, get them off the drugs then their life will improve, their family’s lives will improve…. We’re having some success with that,” he said.

Cremeans said he hopes the program can be expanded in the future to potentially lower the number of overdoses.

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©2019 The Daily Independent (Ashland, Ky.)

McClatchy-Tribune News Service

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