Prescription for a Fatal Drug Overdose
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By Leilani Attilio
Special to The Pilot
The influenza season is in full swing this year, with a record number of patients seeking hospitalization.
However, another epidemic has unwittingly been on the rise in the United States since 1990. The main culprit may lurk inside your home and multiply year after year.
I am talking about prescription medications. Did I fool you?
In North Carolina, drugs have accounted for more than 90 percent of accidental overdose deaths, of which more than half are from opiate drugs like Percocet, Vicodin and OxyContin.
When people use drugs, most of the time they use them with other people or in the presence of others. However, fewer than half actually call 911 in an overdose episode. Because the victim or bystander may possess drugs or drug paraphernalia, they fear calling emergency medical services.
Is it any wonder that fatal drug overdoses have outpaced the number of deaths due to motor vehicle crashes in the United States? Moore County had five accidental fatal overdoses in 2011, compared with two from motor vehicle crashes.
The value of life has trumped criminal prosecution in several states with the adoption of 911 Good Samaritan laws - a move that is gaining traction across North Carolina and among Republicans and Democrats at the state legislature.
The 911 Good Samaritan laws grant criminal immunity to the bystander and victim if the person calls to save the life of the victim. The sooner a call is made for help, the less likely the victim would be admitted to the hospital.
From my nursing standpoint, this would mean an open bed for possibly that flu patient who has been spreading the influenza virus in the emergency department. From the family standpoint, this would mean the victim would sleep in his or her own bed that night and for subsequent nights to come.
Drug overdose deaths are preventable and can be mitigated through the 911 Good Samaritan laws. However, even if a person was to call EMS, they may not arrive quickly enough to administer naloxone, the opiate antidote. The average response time in Moore County is greater than 25 minutes - a less-than-optimal time when the victim has stopped breathing.
Therefore, allowing people at risk for an opiate overdose to have access to naloxone would bridge the gap between when the 911 call is made and when EMS arrives. However, regulatory barriers by the Federal Drug Administration have hampered the ability for the community to gain access to naloxone, which remains a prescription medication.
Until the FDA makes naloxone over-the-counter, community advocates have vocalized support for medical providers to write standing orders of naloxone to be dispensed by lay individuals. By increasing the medication in the community, North Carolina could cut costs on hospitalizations where they spent more than $98 million on accidental overdoses.
Adopting a sane drug policy like the 911 Good Samaritan law and increasing access to naloxone would not only cut costs, but would also, most important, save lives. It is cause liberals and conservatives can rally behind. How about you?
Leilani Attilio lives in Aberdeen. She is a registered nurse and received a Master of Public Health degree from the University of Texas at El Paso. She is an Army veteran and works on drug overdose prevention for the N.C. Harm Reduction Coalition.
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Comments
mooremedic 3 months, 2 weeks ago
Although I applaud your efforts and are in aggreance of the fact that making Narcan an OTC medication may save a few lives I have many questions about your information and the fact you spread it the citizens of Moore County without fact checking. I've been in health care for over 25 years and have seen tons of overdoses and have administered Narcan numerous times. First of all I'm not in the agreeance that you would see much, if any change in the amount of fatal overdoses with the change to OTC availability of Narcan. At most of these incidents the people involved are usually all under the influence and either don't have the capacity to make a sound decision, or to locate and administer the Narcan to the unconscious or non breathing patient. The second and most serious issue, in my opinion, is that these people that use these medications are highly upset when the paramedics come along and reverse their "high" and therefore waste their money. So unless someone remains alert enough to the fact that their partners are not just high but also not breathing and near death, I'm certain not many people would "waste" their partners high. Now as always there are exceptions to this and you may see a few lives saved by families or friends finding said influenced persons and administering Narcan prior to EMS arriving, but those numbers would be very small. Also here in Moore County you're very lucky to have a highly trained EMS system that responds much quicker than the average of 25 minutes that you published. Most responses here average around 9 minutes with many fire departments also providing first responder care with much quicker response times.
fugitiveguy 3 months, 2 weeks ago
"In North Carolina, drugs have accounted for more than 90 percent of accidental overdose deaths"
Isn't this like saying water accounts for more than 90% of drowning deaths?