Increase Access to Overdose Reversal Medications - Revision history

G.Lehrman at 19:21, 7 November 2021

2021-11-07T19:21:45Z

G.Lehrman at 00:39, 17 October 2021

2021-10-17T00:39:00Z

G.Lehrman at 00:38, 17 October 2021

2021-10-17T00:38:15Z

G.Lehrman at 00:35, 17 October 2021

2021-10-17T00:35:37Z

G.Lehrman at 00:32, 17 October 2021

2021-10-17T00:32:37Z

G.Lehrman at 00:16, 17 October 2021

2021-10-17T00:16:01Z

G.Lehrman at 00:11, 17 October 2021

2021-10-17T00:11:33Z

G.Lehrman at 23:48, 16 October 2021

2021-10-16T23:48:42Z

G.Lehrman at 23:48, 16 October 2021

2021-10-16T23:48:20Z

G.Lehrman at 02:41, 11 October 2021

2021-10-11T02:41:17Z

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 <div class="wiki" id="content_view" style="display: block">
 Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map&nbsp;or]] [[ZOOM_MAP_-_Expand_Harm_Reduction_Practices_Associated_with_Opioid_Misuse|Zoom Map (Expand Harm Reduction Practices Associated with Opioid Misuse)]]&nbsp;or [[ZOOM_Map-_Improve_Access_to_Treatments_that_Prevent_Overdose_Deaths|ZOOM MAP - Improve Access to Treatment that ]][[ZOOM_Map-_Improve_Access_to_Treatments_that_Prevent_Overdose_Deaths|Prevent]][[ZOOM_Map-_Improve_Access_to_Treatments_that_Prevent_Overdose_Deaths|&nbsp;Overdose Deaths]]
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 [[Additional_Info_on_Naloxone|Naloxone]] (Narcan) is a prescription medicine that can reverse an opioid overdose or prevent it long enough for the person to receive adequate medical care. It blocks the opioid receptors in the brain to prevent an opioid user’s breathing and heart rates from slowing to fatal levels. Beginning in 2016, thirty-five states have made Narcan available to the general public as an over-the-counter drug to use as a nasal spray. Many other states are now working to pass laws that give police, first responders, and concerned family members the ability to carry and administer Narcan when called to a possible overdose situation. It is either injected or administered in a nasal spray.<br/> <br/> While [[Additional_Info_on_Naloxone|Naloxone]] is not readily available for&nbsp;ordinary citizens, it can be easily administered with little or no formal training. State laws have made it difficult for citizens to obtain the life-saving medication, due to third-party prescription and prescription via standing order policies. The third party-prescription law prohibits the prescription of drugs to someone other than the person who will receive them, while the standing order law prohibits the prescription of drugs to a person not personally examined by the prescribing physician. Although&nbsp;the drug could potentially save more lives if more widely distributed, there is fear of bystanders not summoning medical assistance due to possible prosecution against them.<br/> <br/> According to a report by Community Anti-Drug Coalitions of America&nbsp;(CADCA), a small community in Connecticut has made training for first responders to an overdose mandatory. Officers found a man in an unconscious state and realized he was overdosing. With the administration of Narcan, the man was able to recover from the overdose and regain consciousness.<br/> <br/> Narcan has the potential to be very beneficial in communities with a high opioid problem. Making a community aware of its existence, and its power to reverse overdose is a benefit unlike any other. Narcan will allow victims of substance abuse to be more likely to survive an overdose when first responders are rightly prepared. This medicine is one of need if a community is struggling with an opioid problem.<br/> It has been effective in saving lives, giving people with addiction a chance to realize the depth of their problem and a chance to ask for help.<ref>Hazelden Betty Ford Foundation. Heroin and Prescription Painkillers: A Toolkit for Community Action. 2016.</ref>
 = Key Information =

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 Various federal organizations came together to encourage good faith prescription of naloxone to ordinary citizens. They also&nbsp;encourage bystanders to become "Good Samaritans" by summoning emergency responders without fear of negative legal consequences.
 == State Law Passage ==
-By the end of 2016, all but 3 states, Kansas, Montana, and Wyoming, have passed laws to improve ordinary person naloxone access.
+By the end of 2016, all but 3 states, Kansas, Montana, and Wyoming&nbsp;have passed laws to improve ordinary person naloxone access.
 == Pharmacists ==

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 </ref>
-== Educate about Dangers of Dual use ==
 In 2013 there were 23,153 opioid overdose deaths -- 16,235 involving opioid painkillers, 8,260 involving heroin/opium, and at least 1,342 involving a combination of the two. However, opioid overdoses are seldom due to opioid use alone.&nbsp;&nbsp;The majority of overdoses&nbsp;are a result of mixing an opioid with some other drug. The best way to avoid an opioid overdose is not taking opioids&nbsp;and avoid knowingly mixing opioids with other drugs.&nbsp; It is&nbsp;imperative to understand the risk when opioids are mixed with other drugs and to&nbsp;take extra safety precautions when mixing drugs. These include:

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 [[Additional_Info_on_Naloxone|Naloxone]] (Narcan) is a prescription medicine that can reverse an opioid overdose or prevent it long enough for the person to receive adequate medical care. It blocks the opioid receptors in the brain to prevent an opioid user’s breathing and heart rates from slowing to fatal levels. Beginning in 2016, thirty-five states have made Narcan available to the general public as an over-the-counter drug to use as a nasal spray. Many other states are now working to pass laws that give police, first responders, and concerned family members the ability to carry and administer Narcan when called to a possible overdose situation. It is either injected or administered in a nasal spray.<br/> <br/> While [[Additional_Info_on_Naloxone|Naloxone]] is not readily available for&nbsp;ordinary citizens, it can be easily administered with little or no formal training. State laws have made it difficult for citizens to obtain the life-saving medication, due to third-party prescription and prescription via standing order policies. The third party-prescription law prohibits the prescription of drugs to someone other than the person who will receive them, while the standing order law prohibits the prescription of drugs to a person not personally examined by the prescribing physician. Although&nbsp;the drug could potentially save more lives if more widely distributed, there is fear of bystanders not summoning medical assistance due to possible prosecution against them.<br/> <br/> According to a report by Community Anti-Drug Coalitions of America&nbsp;(CADCA), a small community in Connecticut has made training for first responders to an overdose mandatory. Officers found a man in an unconscious state and realized he was overdosing. With the administration of Narcan, the man was able to recover from the overdose and regain consciousness.<br/> <br/> Narcan has the potential to be very beneficial in communities with a high opioid problem. Making a community aware of its existence, and its power to reverse overdose is a benefit unlike any other. Narcan will allow victims of substance abuse to be more likely to survive an overdose when first responders are rightly prepared. This medicine is one of need if a community is struggling with an opioid problem.<br/> It has been effective in saving lives, giving people with addiction a chance to realize the depth of their problem and a chance to ask for help.<ref>Hazelden Betty Ford Foundation. Heroin and Prescription Painkillers: A Toolkit for Community Action. 2016.</ref>
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 Those close to opioid users have greater knowledge about overdose and how to respond appropriately after they have completed training in naloxone administration compared to peers who learn via an information booklet. Current and former opioid users who complete overdose response training identify an overdose and can tell when naloxone is appropriate as accurately as medical experts. Some studies have found that opioid users who participate in only a brief 5-minute training or learned about naloxone administration through social networks can respond appropriately to an overdose.
-Training first responders such as police, firefighters, and EMTs to administer naloxone may reduce time to overdose rescue, possibly decreasing overdose-related injury and death. Law enforcement officers who participate in naloxone administration and&nbsp;overdose training report increases in knowledge and confidence in managing opioid overdose emergencies after program completion.<ref>https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/naloxone-education-distribution-programs</ref>
+Training first responders&nbsp;to administer naloxone may reduce time to overdose rescue, possibly decreasing overdose-related injury and death. Law enforcement officers who participate in naloxone administration and&nbsp;overdose training report having increased&nbsp;knowledge and confidence in dealing with&nbsp;opioid overdose emergencies after the program is finished.<ref>https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/naloxone-education-distribution-programs</ref>
 = Relevant Research =

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 [[Additional_Info_on_Naloxone|Naloxone]] (Narcan) is a prescription medicine that can reverse an opioid overdose or prevent it long enough for the person to receive adequate medical care. It blocks the opioid receptors in the brain to prevent an opioid user’s breathing and heart rates from slowing to fatal levels. Beginning in 2016, thirty-five states have made Narcan available to the general public as an over-the-counter drug to use as a nasal spray. Many other states are now working to pass laws that give police, first responders, and concerned family members the ability to carry and administer Narcan when called to a possible overdose situation. It is either injected or administered in a nasal spray.<br/> <br/> While [[Additional_Info_on_Naloxone|Naloxone]] is not readily available for&nbsp;ordinary citizens, it can be easily administered with little or no formal training. State laws have made it difficult for citizens to obtain the life-saving medication, due to third-party prescription and prescription via standing order policies. The third party-prescription law prohibits the prescription of drugs to someone other than the person who will receive them, while the standing order law prohibits the prescription of drugs to a person not personally examined by the prescribing physician. Although&nbsp;the drug could potentially save more lives if more widely distributed, there is fear of bystanders not summoning medical assistance due to possible prosecution against them.<br/> <br/> According to a report by Community Anti-Drug Coalitions of America&nbsp;(CADCA), a small community in Connecticut has made training for first responders to an overdose mandatory. Officers found a man in an unconscious state and realized he was overdosing. With the administration of Narcan, the man was able to recover from the overdose and regain consciousness.<br/> <br/> Narcan has the potential to be very beneficial in communities with a high opioid problem. Making a community aware of its existence, and its power to reverse overdose is a benefit unlike any other. Narcan will allow victims of substance abuse to be more likely to survive an overdose when first responders are rightly prepared. This medicine is one of need if a community is struggling with an opioid problem.<br/> It has been effective in saving lives, giving people with addiction a chance to realize the depth of their problem and a chance to ask for help.<ref>Hazelden Betty Ford Foundation. Heroin and Prescription Painkillers: A Toolkit for Community Action. 2016.</ref>
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 Researchers believe that communities that have programs aimed at training bystanders to respond to opioid overdoses have experienced a reduction in opioid overdose death rates quicker than communities without these programs.&nbsp;<ref>https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/naloxone-education-distribution-programs</ref>
-Family and friends of opioid users have greater knowledge of opioid overdose and ability to respond appropriately after receiving training in naloxone administration than peers who learn about opioid overdose and naloxone via an&nbsp;information booklet. Current or former opioid users who have received training in overdose response appear to identify overdose and recognize conditions when naloxone is appropriate as accurately as medical experts. Some studies suggest that opioid users who have participated in only a brief 5-10 minute training or learned naloxone administration through social networks can respond appropriately to an overdose.
+Those close to opioid users have greater knowledge about overdose and how to respond appropriately after they have completed training in naloxone administration compared to peers who learn via an information booklet. Current and former opioid users who complete overdose response training identify an overdose and can tell when naloxone is appropriate as accurately as medical experts. Some studies have found that opioid users who participate in only a brief 5-minute training or learned about naloxone administration through social networks can respond appropriately to an overdose.
 Training first responders such as police, firefighters, and EMTs to administer naloxone may reduce time to overdose rescue, possibly decreasing overdose-related injury and death. Law enforcement officers who participate in naloxone administration and&nbsp;overdose training report increases in knowledge and confidence in managing opioid overdose emergencies after program completion.<ref>https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/naloxone-education-distribution-programs</ref>

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 [[Additional_Info_on_Naloxone|Naloxone]] (Narcan) is a prescription medicine that can reverse an opioid overdose or prevent it long enough for the person to receive adequate medical care. It blocks the opioid receptors in the brain to prevent an opioid user’s breathing and heart rates from slowing to fatal levels. Beginning in 2016, thirty-five states have made Narcan available to the general public as an over-the-counter drug to use as a nasal spray. Many other states are now working to pass laws that give police, first responders, and concerned family members the ability to carry and administer Narcan when called to a possible overdose situation. It is either injected or administered in a nasal spray.<br/> <br/> While [[Additional_Info_on_Naloxone|Naloxone]] is not readily available for&nbsp;ordinary citizens, it can be easily administered with little or no formal training. State laws have made it difficult for citizens to obtain the life-saving medication, due to third-party prescription and prescription via standing order policies. The third party-prescription law prohibits the prescription of drugs to someone other than the person who will receive them, while the standing order law prohibits the prescription of drugs to a person not personally examined by the prescribing physician. Although&nbsp;the drug could potentially save more lives if more widely distributed, there is fear of bystanders not summoning medical assistance due to possible prosecution against them.<br/> <br/> According to a report by Community Anti-Drug Coalitions of America&nbsp;(CADCA), a small community in Connecticut has made training for first responders to an overdose mandatory. Officers found a man in an unconscious state and realized he was overdosing. With the administration of Narcan, the man was able to recover from the overdose and regain consciousness.<br/> <br/> Narcan has the potential to be very beneficial in communities with a high opioid problem. Making a community aware of its existence, and its power to reverse overdose is a benefit unlike any other. Narcan will allow victims of substance abuse to be more likely to survive an overdose when first responders are rightly prepared. This medicine is one of need if a community is struggling with an opioid problem.<br/> It has been effective in saving lives, giving people with addiction a chance to realize the depth of their problem and a chance to ask for help.<ref>Hazelden Betty Ford Foundation. Heroin and Prescription Painkillers: A Toolkit for Community Action. 2016.</ref>
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 = Key Information =
-There is some evidence that opioid overdose education and naloxone distribution programs increase knowledge of appropriate overdose response among participating opioid users and others likely to encounter an overdose situation. Naloxone distribution through such programs is associated with reduced overdose deaths and appears to increase participants'&nbsp;confidence in their ability to respond effectively to overdose situations. However, additional evidence is needed to confirm the effects.&nbsp;<ref>https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/naloxone-education-distribution-programs</ref>
+Opioid overdose education and naloxone distribution programs aimed at opioid users and individuals likely to be near people who overdose increase knowledge on how to effectively respond when someone is experiencing an overdose. Participation in the naloxone distribution programs is linked to a reduction in overdose deaths and an increase in confidence when responding to overdose. More research is still needed to confirm these benefits.&nbsp;<ref>https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/naloxone-education-distribution-programs</ref>
 Communities that implement programs to train potential bystanders to identify an opioid overdose and respond with naloxone appear to reduce opioid overdose death rates more than communities that do not implement such programs.<ref>https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/naloxone-education-distribution-programs</ref>

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 [[CP_-_Improve_Access_to_Treatments_that_Prevent_Overdose_Deaths|CP - Improve Access to Treatments that Prevent Overdose Deaths]]
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 == Waive Copays ==
-Many people who are prescribed Narcan (nearly 35%) don’t pick it up—presumably because they can’t afford the co-pay.<ref>https://www.healthcaredive.com/news/aetna-launches-new-policies-to-combat-opioid-crisis/512866/</ref><br/> Having insurers eliminate the co-pay is one strategy to help address that. [https://www.aetna.com/index.html?cid=ppc-700000001035216-National_Always%20On_Branded_Aetna_Exact-Aetna-aetna&s_dfa=1&gclid=Cj0KCQiA38jRBRCQARIsACEqIeuilyQ_mSIjuCUt394XAuPY7X7VLnJ16hmHFgFYPcLvvOwo4NUwmxkaAsEhEALw_wcB&gclsrc=aw.ds Aetna] is currently the first national payer to waive copays for Narcan for its fully-insured commercial members. This will improve access by eliminating potential&nbsp;financial barriers to the lifesaving drug."<ref>https://www.healthcaredive.com/news/aetna-launches-new-policies-to-combat-opioid-crisis/512866/</ref>
+Many people who are prescribed Narcan (nearly 35%) don’t pick it up—presumably because they can’t afford the co-pay.<ref>https://www.healthcaredive.com/news/aetna-launches-new-policies-to-combat-opioid-crisis/512866/</ref><br/> Having insurers eliminate the co-pay is one strategy to help address that. [https://www.aetna.com/index.html?cid=ppc-700000001035216-National_Always%20On_Branded_Aetna_Exact-Aetna-aetna&s_dfa=1&gclid=Cj0KCQiA38jRBRCQARIsACEqIeuilyQ_mSIjuCUt394XAuPY7X7VLnJ16hmHFgFYPcLvvOwo4NUwmxkaAsEhEALw_wcB&gclsrc=aw.ds Aetna] is currently the first national payer to waive copays for Narcan for its fully-insured commercial members. This will improve access by eliminating potential&nbsp;financial barriers to the lifesaving drug.<ref>https://www.healthcaredive.com/news/aetna-launches-new-policies-to-combat-opioid-crisis/512866/</ref>
 = Tools & Resources =