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EMS NC Harm Reduction Coalition Community Care of NC

EMS Supports and Trains Law Enforcement to Carry Naloxone in North Carolina. EMS NC Harm Reduction Coalition Community Care of NC. Drug Overdose in North Carolina. Primary Cause of Death Due to Unintentional Poisonings: N.C., 2011. Medication/Drug--91% -Opioids/Cocaine--56%

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EMS NC Harm Reduction Coalition Community Care of NC

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  1. EMS Supports and Trains Law Enforcement to Carry Naloxone in North Carolina EMSNC Harm Reduction Coalition Community Care of NC

  2. Drug Overdose in North Carolina

  3. Primary Cause of Death Due to Unintentional Poisonings: N.C., 2011 Medication/Drug--91% -Opioids/Cocaine--56% -Other/Unspecified drugs--30% -Anti-epileptic and sedative-hypnotic drugs--4% -Non-opioid--1% Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, 2011 Analysis by Injury Epidemiology and Surveillance Unit

  4. Poisoning Deaths: N.C., 1999-2012* • In 1999, the number of unintentional poisoning deaths was 279; in 2012, the number of deaths was 1,101, an increase of over 300%.

  5. Unintentional Poisoning Deaths by County: N.C., 1999-2009

  6. Naloxone

  7. Naloxone • Non-addictive prescription medication reverses opiate overdose • Cannot be abused nor cause overdose • Restores breathing and consciousness • Administer intramuscular or nasal spray • Onset: One to three minutes • Duration: 30 to 90 minutes

  8. How Naloxone Works?

  9. Blue or pale skin Limp body Pulse (heartbeat) slow or not there at all Throwing up Passing out Choking, gurgling snoring sound Breathing very slow, irregular, or stopped Signs of Overdose

  10. Storage of Naloxone • Keep out of direct sunlight • Hospira storage recommendations: 20 to 25°C (68 to 77°F) • Gammon et al. clinical study: • Naloxone maintained close 90% concentration when subjected to ~21 and ~129 degrees Fahrenheit temperatures every twelve hours for 28 days

  11. Misconceptions of Naloxone Naloxone makes people violent. If you give an overdose antidote to drug users, they will abuse more drugs. We can't trust a person who is high to respond appropriately in a life-threatening situation. Naloxone will keep drug users from seeking treatment.

  12. North Carolina Legislative Update - SB20

  13. Senate Bill 20 • Effective April 9, 2013 • Two components: • Naloxone Access • Good Samaritan Immunity NC Legislation Overview

  14. SB20: Naloxone Access • Prescribers may prescribe naloxone to a person at risk of overdose or any other person “in a position to assist a person at risk of experiencing an opiate-related overdose.” • Prescribers may prescribe naloxone via standing order • Bystanders may administer naloxone • All parties acting as authorized by law are immune from civil or criminal immunity so long as they act in good faith NC Legislation Overview April 17, 2014

  15. SB20: Good Samaritan • Provides limited criminal immunity to any person who seeks medical assistance in good faith for person experiencing drug overdose • Possession of small amounts of drugs • Possession of drug paraphernalia • Same immunity applies to victim • Provides limited criminal immunity to minors who seek medical assistance for person experiencing alcohol overdose • Must remain with victim until help arrives • Must give name when seeking help • Immunity does NOT extend to victim NC Legislation Overview April 17, 2014

  16. SB20 Supporters This law was supported by the NC Sheriffs’Association, NC Association of Chiefs of Police, NC Hospital Association,the NC Medical Board, the NC Medical Society, and the NC Child Fatality Task Force.

  17. How to Start a LEO Naloxone Program

  18. US LEOs Carry Naloxone • Arundel PD, MD • Bartlett PD, IL • Benzie County Sheriff, MI • Bloomingdale PD, IL • Buffallo PD, NY • Carrboro, NC • Starts June 2014 • Countryside PD, IL • Downers Grove PD, IL, • DuPageCounty Sheriff, IL • Espanola PD, NM • Glen Cove, NY • Gloucester PD, MA • Grand Traverse County Sheriff, MI • Hinsdale PD, IL • Indianapolis Metropolitan PD, INLorain PD, OH • Nassau County PD, NY • New York City PD (120th Precinct), NY • Oakland County Sheriff, MI • Quincy PD, MA  • 202 OD Reversals as of 12/18/2013 • Rensselaer Sheriff, NY • Suffolk County PD, NY • Wheaton PD, IL • Wood Dale PD, IL Source: NC Harm Reduction Coalition

  19. Step 1: Buy In • Get Buy-In from Sheriff and/or Police Chief and Local EMS Authority • Video: Lieutenant Detective Pat Glynn: Saving Lives with Narcan • Lieutenant Detective Pat Glynn: Saving Lives with Narcan • https://vimeo.com/47686862

  20. Step 2: Get EMS Director to Approve Program • Have chief/sheriff and EMS director develop policies and procedures in line with operating a program • Orange County has developed a policy that can be edited for the needs of other jurisdictions • Submit to EMS director James “Tripp” Winslow

  21. Step 3: Figure Out How to Pay for the Naloxone • Cost per unit • Nasal Naloxone Kits cost $33-67 • Inter muscular naloxone kits cost under $10 • New Evzio kit will cost $150-$300 • Payment Options • Can have EMS pay • Use drug seizure money • Work with health department on funding • Use local Project Lazarus Funding • Other…

  22. Step 4: Order Naloxone and Naloxone Storage • Can use existing EMS relationship with medication order • Order through manafactuer and ship to local pharmacy • Contact NCHRC if you need help

  23. Step 5: Set Up Documentation System • Have a meeting to discuss how you would like to document dispensing naloxone and overdose reversals. • OC Health Department and NCHRC have sample forms you can edit

  24. Step 6: Set Up A Training • Introductions • 5min • Law Enforcement Use of Naloxone • 5min • Have Police Chief and EMS Trainer lead this • State and Local Context (Overdose in Specific City/County, SB 20 Good Samaritan/Naloxone Access, etc.) • 20min • Have NC Harm Reduction Coalition lead • Naloxone Protocol Training • 40min • Have EMS Trainer lead • Include skill practice session • OC EMS has extra nasal naloxone demo kits for use • Q+A/Closing • 10min

  25. Step 7: Set Up A Naloxone Dispensing Day • Could be the same day as training • Dispense to all the officers in the same week so you can set up a date to replace expired naloxone for everyone when it expires • Have Set up a standing order for the EMS official to dispense to LEOs • See OC Health Department or NCHRC for examples

  26. Contact Information • Robert Childs • NCHRC Executive Director • 336-543-8050 • Robert.BB.Childs@gmail.com • Tessie Castillo • Law Enforcement Relations Coordinator • 919-809-7718 • Tswopecastillo@gmail.com • Mike Lancaster • CCNC

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