Pubdate: Fri, 11 Aug 2017
Source: Seattle Post-Intelligencer (WA)
Copyright: 2017 Seattle Post-Intelligencer
Contact: P.O. Box 1909, Seattle, WA 98111-1909
Author: Stephen Cohen


Public health officials are promoting the use of the drug naloxone to
help save people from opioid overdoses.

Seattle's opioid crisis is a complicated medical, political and
emotional issue, but state leaders are attempting to tackle one of the
most immediate concerns facing those on the front line of the fight:
Keeping users alive during an overdose.

The Seattle Police Department implemented a nasal naloxone (also known
Narcan) program in March 2016, training 60 bike officers to administer
the drug to anyone they believed to be suffering from an opioid
overdose. The program has been a modest success, with officers
reviving 20 people thus far according to Officer Steve Redmond, and
there are hopes the program can be expanded department wide.

Opioids like heroin, fentanyl and oxycodone account for six of 10 drug
overdose deaths in America, according to the National Conference of
State Legislators. From 2012-16, 995 people in King County died from
opioid overdoses, according to the Washington State Department of Health.

At a summit discussing the state's opioid epidemic last week, experts
made sure to emphasize that while naloxone isn't a silver bullet to
combat opioid addiction, it can save lives -- at least in the short

"It's a great intervention," said Caleb Banta-Green of the University
of Washington's School of Public Health. "But it's not a complete

The drugs generally kill by slowing the body's breathing, which can
lead to a fatal heart arrhythmia. Naloxone attaches to the same brain
receptors as opioids, usually restoring normal breathing within
minutes. The effects can last for more than an hour, giving first
responders valuable time to stabilize patients and get them to a hospital.

Seattle Fire Department Capt. Jonathan Larsen remembered encountering
naloxone, which used to be administered by a fast-acting intravenous
injection, for the first time after it was approved by the Federal
Drug Administration in 1971.

"We give the drug, in 30 seconds to a minute, the person opens their
eyes, looks around like they've been thrown out of bed, tells us they
don't use drugs, impugns our mothers and proceeds to throw up," Larsen
said. "That's pretty cool. It's like going to a revival meeting."

In 2010 Washington made it legal for naloxone to be prescribed to
anyone who might witness an opioid overdose. A 2015 law allowed
prescriptions entities like police departments, homeless shelters or
social service agencies. Good Samaritan laws protect anyone acting in
good faith to reverse an overdose from prosecution for misdemeanor
drug possession.

When administered with a nasal spray, the drug takes a little big
longer to work, but the effects can be gentler for users. Despite the
program's success so far, Redmond said there are cultural issues that
need to be overcome for naloxone programs to be expanded, particularly
among law-enforcement officers resistant to taking on duties typically
reserved for paramedics.

Banta-Green cautioned that overdose-reversing drugs are only a small
part of the conversation about how to treat opioid addiction, pointing
out that naloxone reduces mortality rates among users by about 6
percent. Long-term treatment drugs like methadone and buprenorphine,
on the other hand, can cut opioid death rates in half.

But discussing naloxone and other methods of combating addiction can
be jumping-off points for larger conversations about the crisis,
Banta-Green said, particularly when it comes to reducing the stigma
attached to opioid use and finding effective treatment options.

"Naloxone is the great gateway drug for a conversation about
addiction," he said.

Banta-Green, Redmond and Larsen were among the first-responders,
medical workers, policymakers and community leaders in attendance last
week during the Summit on Reducing Supply of Illegal Opioids in
Washington at UW.
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