There is no shortage of questions that Laura Brennan, an education coordinator with the Oklahoma Center for Poison & Drug Information, hears when stationed at a health fair or community event.
As an employee of the public health agency charged with operating the state’s poison hotline, Brennan encourages Oklahomans to call the number (1-800-222-1222) if they or someone they know has taken the wrong medication, ingested pesticides or household products or just has a question. In the wake of the state’s opioid epidemic, when nearly four out of five unintentional poisoning deaths are a result of prescription drug abuse, Brennan encounters an increasing number of questions and personal stories surrounding prescription painkillers.
“Everywhere I go, I meet someone who has been touched by the opioid epidemic,” Brennan told Oklahoma Gazette. “I travel the entire state, all 77 counties. … It doesn’t matter who they are, what they do for a living or where they live — they’ve been affected. People are sharing stories of stolen medicine, and others are asking how to dispose of medicines.”
Around the country, the misuse and abuse of opioids is an escalating and preventable public health crisis. Opioid drugs include opium, morphine, heroin and similar drugs used to treat acute pain following trauma or surgery or to aid patients with painful terminal or chronic diseases, such as cancer.
In Oklahoma County, where Karin Leimbach teaches the general public the right way to store and dispose of prescription drugs — an approach to prevent opioid abuse and misuse from the beginning — she answers questions centered on treatment and what to do in an overdose situation.
“While our main focus is on safe use, storage and disposal, we do speak to people who are past the point of prevention,” said Leimbach, who is a member of the Substance Use Prevention Alliance (SUPA), a local coalition brought together by the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) and DCCCA to address the epidemic of abuse and misuse of legal and illegal substances. “We share 211 (OKC HeartLine) as a resource for who to call to find out about treatment facilities. Then, naloxone.”
Oklahomans past the point of prevention comes as no surprise in the wake of the statistics. Oklahoma ranked No. 1 nationally for non-medical use of painkillers for all age groups 12 and older during 2012 to 2014, according to a July report issued by the federal Substance Abuse and Mental Health Services Administration.
With a high number of Oklahomans using prescription pain pills — even responsibly, under a doctor’s care — more attention is being placed on preventing opioid-overdose deaths with naloxone, or Narcan, the drug that can reserve the overdose.
Reversing the damage
Fighting opioid drug overdose with naloxone became a goal of the Oklahoma State Department of Health in 2013. At that time, the agency joined other state health and law enforcement agencies in developing Oklahoma’s plan, Reducing Prescription Drug Abuse in Oklahoma, which listed programs, policies and initiatives to address the state’s opioid epidemic. One such initiative was expanding access to naloxone.
Following legislation changes, the health department began training emergency medical personnel across the state on the use of naloxone. Meanwhile, the Oklahoma Department of Mental Health and Substance Abuse Services trained law enforcement agencies. Eventually, the health department’s training expanded to fire departments and rural volunteer fire departments.
“Naloxone is an opioid antagonist, and what that means is naloxone reverses an opioid-related overdose, whether that is prescription painkillers, opioids or heroin,” said Avy Redus, a project coordinator for unintentional poisoning and overdose with the health department.
While naloxone has become more widespread in the last few years among first responders and law enforcement, the health department advocates for public use for preventing overdoses. In May, the potential for naloxone’s use in Oklahoma grew even further when Gov. Mary Fallin signed a law to allow pharmacies to dispense the medication to anyone.
As part of an effort to increase access to naloxone, there are seven sites in Oklahoma City where naloxone kits can be obtained for free. Additionally, pharmacies across the state carry the kits for purchase.
“There is still a learning curve in rural Oklahoma,” Redus said about awareness around naloxone and how it can prevent opioid overdose. “With our emergency medical personnel trained and with law enforcement trained, along with public awareness through local coalition and more clinicians co-prescribing naloxone, that has helped drum up attention and information.”
Last week, as part of International Overdose Awareness Day, Leimbach held up a package of Narcan to show students on the campus of the University of Central Oklahoma. She recommended giving Narcan to someone showing signs of an overdose — pale skin, loud gurgling noises and blue lips and fingertips. As a nasal spray, it can be administered by tilting the head back and spraying the dosage up the nostril. Once administered, she advocated for calling 911. The drug replaces the opioids and allows the body time to recover and breathe again, but she said further medical assistance is needed.
Leimbach’s message goes beyond what the drug can do. First, drug overdoses don’t just happen to those struggling with drug abuse, as they can happen by simply misunderstanding a legal prescription. Second, the first responders at a potential overdose, before emergency personnel arrive, are often family members and friends. Being familiar with Narcan could help save a life, just like CPR.
Print headline: Preventing death, Saving someone from a prescription pill overdose is as easy as knowing about naloxone.