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Overview of Naloxone Rescue Kits - 12-08-14

Last Revised: 03-12-14

on 28 January 2015

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Transcript of Overview of Naloxone Rescue Kits - 12-08-14

Opioid Lethal-Dose Rescue Kit

The Opioid Problem
Aaron Kochar
Director of Prevention & Education

Lethal Drug dose is the leading cause of accidental death in America

Lethal Drug doses have quadrupled in Indiana since 1991

Lake County Drug Mentions in Drug-Caused Deaths:

Paths to Prescription Drug Abuse
42 year-old experience chronic back pain
17 year-old riffling through their friend’s grandma’s medicine cabinet

Paths to Heroin Abuse
Lower cost, higher purity
Decreasing the supply of Rx Drugs doesn’t solve the addiction

The Lethal Opioid Dose
Opioid agonist attaches to brain’s receptors
Depresses Central Nervous System function
Oxygen deprivation leads to coma and death
Death occurs between 1 to 3 hours from administration of lethal dose
This provides a window to save an imperiled person from a potentially lethal opioid dose
Time is of the essence

Marketed as Narcan®
An Opioid Antagonist
Kicks off the agonist or partial agonist
Blocks them from attaching
Stops opioid receptors from firing

No Euphoric Effects
Not a drug of abuse
Serious side effects are rare
FDA approved in 1971
Used for decades by hospitals and EMTs intravenously
Studies show equal effectiveness intramuscularly or intranasaly
IN delivery prescribed as an off-label application since 1999

Since 1996:
53,032 people trained to intervene with naloxone
10,171 people have had an overdose reversed (2010)

Indiana's Lifeline Law
Passed unanimously at every stage in the General Assembly
Final passage: March 6, 2014
Emergency Bill: March 27, 2014
Authorizes Indiana EMS Commission to set Standards:
Use, and

Authorizes all tiers of emergency medical responders, firefighters, and law enforcement officers
Administer naloxone
Civil Immunity, if procedures followed
Their Department

Authorizes prescribing and dispensing of Naloxone

Provides sentence mitigation to one convicted of controlled substances crime in part because that person sought help for an imperiled person

Benefits of Naloxone
Not a solution to addiction, but it saves a life so the imperiled person has a chance to seek treatment
Research shows that those saved by Naloxone are more likely to seek treatment

Technological Medical Advance empowers bystanders with minimal training to become life savers
Public Automated External Defibrillators (AEDs)
Epinephrine Autoinjector (EpiPens)

Intranasal Naloxone Kit costs approximately $35 to $50
Naloxone distribution is estimated to cost $400 for every quality-adjusted year of life gained;
Medical intervention are usually justified if the cost is under $50,000.

Criticism of Widespread Naloxone Use
Naloxone will provide a safety net to enable uses to engage in riskier behavior
This criticism relies on a person with a substance abuse disorder's ability to make a rationale argument in relation to their drug seeking behavior;
Unfortunately, the grasp of addiction isn't easily broken by a logical argument.

Should be left to Medical Professionals
Just as lay people can save lives with CPR, AEDs, and EpiPens with minimal training, so too can a lay person use naloxone to save an imperiled person’s life

Potentially Violent
In the rare, anecdotal reports where violence occurs because the imperiled person’s “high was ruined”, the amount of naloxone used was likely not indicated
In the past, 4 to 10 mg/mL was the recommended dose. This induced rapid withdrawal symptoms, going from near death to stone sober. Rescue kits use 2 mg/mL doses for a gradual save.

207 Million Opioid Prescriptions in the U.S.
Full transcript