WE Care Coalition
Narcan must become as commonplace as CPR
BY MARK CALARCO, OPINION CONTRIBUTOR
While the world continues to navigate the impacts of the COVID-19 pandemic, our other epidemic hasn't gone away: The rate of opioid overdoses, already a national nightmare, has accelerated since the onset of COVID-19.
President Trump has labeled the opioid situation a national emergency, saying "it is a serious problem the likes of which we've never had." Democratic presidential nominee Joe Biden is proposing an expansion in healthcare benefits, including Medicaid, to guarantee that insurers cover substance use disorder treatment.
It's time to end this continuing tragedy. One of the ways to do this is by making naloxone (better known by the brand name Narcan®) - a safe, effective and use-specific antidote to opioid overdose - as common among bystanders as CPR.
Narcan can be purchased in its generic or branded forms by anyone, without a prescription, at any participating pharmacy in the U.S. All major drug store chains including Walgreen's, RiteAid and CVS carry Narcan.
Narcan is designed specifically to block and reverse the impact of opioids - a family of dangerous drugs that includes oxycodone, hydrocodone, fentanyl and heroin - on the respiratory system. The FDA-approved medication works in seconds and is available either in single-use nasal spray, or as a muscular auto-injector device similar to an EpiPen.
Cost should not be a barrier to accessing Narcan; in fact, 97 percent of people covered by insurance have access, and 72 percent have a co-pay of $10 or less. Nearly all (98 percent) of Medicare Part D and Medicare Advantage plans cover the cost of Narcan.
A worsening crisis
Suppliers and insurance companies are loosening guidelines for obtaining Narcan because the need couldn't be more dire. Drug deaths have risen 13 percent in the U.S. so far this year, compared to 2019, and more than 20 states have reported increases in opioid-related mortality. Since onset of COVID-19, overdoses have increased by roughly 18 percent each month, compared to the same month in 2019.
Among other reasons, one major cause for this increase in addictions and overdoses is clear: We're in a mental health emergency. Isolation due to lockdowns and the increase in social distancing, while necessary and understandable, can affect decision making and the handling of stressful situations. For many, these conditions contribute to the use of opioids which have become increasingly powerful. The Substance Abuse and Mental Health Services Administration (SAMHSA) disaster distress helpline has seen a nearly 900 percent increase in calls since the pandemic began. In the latest CDC study of U.S. adults in June 2020, 13.3 percent of respondents reported having started or increased substance use to cope with stress or emotions related to COVID-19.
Let's remove the stigma and prepare ourselves
As a nation, we need to get over the stigma of dealing with an overdosed individual. In terms of a medical emergency, an overdose is no different than insulin shock, stroke, or heart attack. A person who has overdosed is simply a fellow human being in need of aid.
Compassion demands a response.
According to research, it's more likely for a bystander to be called upon to administer Narcan than CPR. What's more, Narcan is easier than CPR to administer. Signs to look for in an overdose victim include unresponsiveness, slow heartbeat, blue fingernails or lips, clammy skin, and pinpointed eye pupils. They may have stopped breathing.
There is no danger in giving Narcan needlessly. If a person isn't overdosing, administering the drug won't harm them. Not only is it a benign medication, you don't even have to be directed by a first responder to administer it.
If using the nasal spray, simply insert the nozzle into the person's nostril and press the plunger. That's it. Call 911 and roll the person on their side to protect them against aspirating once they begin recovering, which should occur in 2-3 minutes.
Put Narcan everywhere
In order to stem our national overdose epidemic, Narcan must be omnipresent in our public places, in our workplaces and schools, and in our homes. This is not an unachievable or unreasonable goal. Years ago, CPR became a public health imperative. CPR became common after the American Red Cross, the American Heart Association and other major national organizations assumed the task of training. In today's world, Narcan needs to have similar importance.
As we observe International Overdose Awareness Day, it's time to establish a new public health priority. Surgeon General Jerome Adams, in the first Surgeon General advisory of its kind in the past 15 years, is urging every American to carry Narcan, and be trained to administer it. If your pharmacy doesn't have Narcan in stock, ask them to carry it. If it's available, spend the co-pay, purchase a dose, and carry it with you.
As a society, Americans are a generous people. We're willing to give a few dollars to a homeless person, donate to a local charity, or contribute in times of national disaster. Narcan can be an inexpensive way to ensure you're helping a family member, co-worker, or fellow human being.
When seconds count, won't it feel rewarding to know you have the way to save a person's life, just sitting in your purse, backpack or briefcase?
Dr. Mark Calarco is National Medical Director for Clinical Diagnostics, American Addiction Centers. AAC is currently offering free Narcan training at all its U.S. treatment centers.