Enlisting antagonists in the fight against opioid abuse
Tuesday, March 28, 2017
Not all opioid antagonists come in a bottle. Some behavioral healthcare providers are fighting the scourge of opioid abuse by equipping colleagues, patients, families and community partners against the epidemic.
"The demand for substance-abuse services is skyrocketing, and a large driver of that is the opioid-abuse problem," said Bruce Goldman, LCSW, director of substance-abuse services at Zucker Hillside Hospital (Glen Oaks, New York). He added that the hospital's patient population clearly reflects the epidemic.
"I've been in this field for many years, and I've never seen so many sudden, tragic deaths of otherwise healthy, young, productive people," Goldman said.
Zucker Hillside treats about 1,200 outpatients for substance-use disorders at any given time. Whereas most patients previously needed care for cannabis, cocaine or alcohol issues, Goldman said, more now seek help for opioid abuse.
South Oaks Hospital (Amityville, New York) has experienced similar shifts.
"We see at least 100 patients a month," said Jean Jackson, the facility's administrative director of substance-use disorders. "Of those 100, I estimate that 85 percent or more have opioid issues."
Taking the fight to the community
South Oaks and Zucker Hillside behavioral healthcare pros work to curb overdose deaths in the community by distributing Narcan kits throughout Suffolk, Nassau and Queens counties.
Together, the teams have supplied more than 1,100 effective Narcan kits. Community health fairs are a venue of distribution, as well as monthly community training on the South Oaks campus. All patients receiving care for opioid-use disorder receive the kits and training, as do their loved ones. Anyone is eligible.
An opioid antagonist, Narcan (naloxone) immediately halts an overdose. Kits contain two premeasured doses of the intranasal spray and two atomizers. In case of overdose, quick administration of the drug can mean the difference between life and death.
Narcan has few associated side effects, and allergic reactions are rare, so it is safe for anyone who needs it. The teams who provide community groups with Narcan coaching recommend that clinicians, law enforcement personnel and loved ones watch for signs of overdose.
"Any changes in a person's behavior or level of consciousness — like lethargy, physical coordination or decreased or irregular breathing patterns — would warrant the administration of Narcan. Better to be safe than sorry," Jackson said. "Even if the symptoms aren't related to opioid overdose, Narcan is not harmful."
Enlisting emergency departments
Besides assisting at-risk patients and those close to them, the Naloxone Saturation Campaign provides kits and training to patients who present with opioid overdose at the emergency departments (EDs) of Southside Hospital (Bay Shore, New York) and Staten Island University Hospital's north and south campuses.
Within 40 days of campaign launch, one ED had already distributed 86 kits.
"Trainers have rallied the community to talk about this issue and work together to help solve the epidemic," Goldman said. Furthermore, family members of addiction-recovery patients have shared with Zucker Hillside staff members that they used the kits during emergencies to administer Narcan.
"As a result, they saved their loved ones' lives."
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