OVERDOSE PREVENTION PREHOSPITAL ADMINISTRATION OF NALOXONE RENEE YANDEL

OVERDOSE PREVENTION PRE-HOSPITAL ADMINISTRATION OF NALOXONE RENEE YANDEL HIV ALLIANCE PAT MOORE D. I. N. T.

Amnesty in overdose reporting � Senate Bill 839 of the 2015 Oregon Legislative Session. � A person who calls EMS or Police to report an OD, along with the actual patient, may not be arrested or prosecuted for the following crimes if the evidence was obtained pursuant to the emergency response: � Frequenting a Drug House, Possession of Controlled Substance, Unlawful Possession of Hydrocodone, Methadone, Oxy, Heroin, Marijuana, Cocaine, Meth, Rx, or Paraphernalia w/ intent to sell. � Pre-existing arrest warrants will NOT be served upon the reporting party or patient if the warrant was issued for any of the crimes listed above, or for a violation of Parole or Probation pursuant to such an offense

Douglas county overdose rates: � 33 deaths in 30 months (2012 to 2014): � 24 of the 33 (73%) by Opiates, including synthetic opioids. � 75% of Opiate deaths involved Rx; the other six were by Heroin. �Two-thirds of ALL fatal ODs were via Rx; nine via illicit drugs. �Meanwhile, Heroin arrests in Douglas County topped 200 for the first time ever, in the calendar year 2015. �Naloxone has been issued to select, trained LE officers in DINT, the county jail, and Winston Police Department.

Oregon Senate Bill 384 �You can use naloxone on someone else. �You will not be liable if something bad happens (mostly). �A variety of organizations can train individuals and give them naloxone. �You can also take a “training certificate” to a pharmacy. �Pharmacists can train/prescribe. New House Bill 4124 �Social service agencies: trained staff use, not just by individual named employee. New House Bill 4124

What is naloxone ? • Opioid antagonist-temporarily stops effects of opioids • Cannot be used to get high, not addictive • No effect if the person has not taken Opioid • Effective even if Opioid taken w alcohol or other drugs • No risk if the person has not taken Opioid or not overdosing

What is naloxone? • Administered via injection or nasal • Injection Dose 1 m. L vial, kits contain 2 • Onset of action 3 -15 mins • Duration of action: 3045 mins

Nasal naloxone 7

Auto-injector 8 8

Narcan Spray 9

Naloxone Training OAR 333 -055 -0100 through 333 -055 -0110 • Training must meet OHA criteria • Training must be “approved” by a licensed physician or Nurse Practitioner • Retraining every 3 years • OHA Training Video: https: //www. youtube. com/watch? v=ws. N 0 ij. Ln. K 2 k&fe ature=youtube

CDC Report 2015 Opioid Overdose Prevention Programs Providing Naloxone to Laypersons 82. 8% of the reported reversals were done by people who use drugs and 9. 6% by family and friends of a user. Service providers came in at 0. 2%. “An opioid overdose is a life-threatening medical emergency. If laypeople have naloxone, they can start the process of reviving the person before paramedics or law enforcement come through the door. ” Dr. Stephen Jones, researcher and author of the report

HIV Alliance Naloxone Distribution �December 2015 -OR DOJ Settles with Insys �January 2016 - Lines for Life (LFL) receives funds from settlement to prevent Opioid abuse and misuse �April 2015 -HIV Alliance receives funding through LFL �July 2016 - HIVA launches Naloxone project in Lane Co. �January 2017 -HIVA launches Naloxone project in Douglas Co. �February 2017 - HIVA partners with Max’s Mission to host a community training and distributes 22 doses to family/friends

HIVA kit • Naloxone • Syringes • Face shield • Alcohol wipes • Sharps container • Info & Instructions

NEX survey Have you ever witnessed a drug overdose ? 83% reported YES Have you ever overdosed? 53% reported YES Have you overdosed in the last yr? 20% reported YES What type of insurance do you have? OHP 63% None 27% Medicare 5% VA 3% Private 2%

Syringes Exchanged 2013 -2016 (Douglas County) 120000 107253 103299 100000 84195 84165 76548 Contacts 1889 65799 60000 40000 1003 1036 13 -14 14 -15 20000 0 13 -14 14 -15 15 -16 Needles Distributed Needles Destroyed 15 -16

Contact Information Renee Yandel HIV Alliance Executive Director 541. 342. 5088 x 113 ryandel@hivalliance. org Lieutenant Pat Moore, Commander Douglas Interagency Narcotics Team 541. 440. 4474 pmoore@cityof roseburg. org