Riverside, California 2021-05-08 10:54:22 –
The project already has 47 hospitals, promising to dispense overdose antidotes when at-risk patients are discharged from the emergency department.
When doctors prescribe life-saving antidotes against opioid overdose, patients struggle to fill them for about 5% of their time.
But what if a hospital doctor simply gives a vial of naloxone to a patient who is worried, especially a patient who has just been rushed to the emergency room after overdose of fentanyl, prescription opioids, or heroin?
That is the idea behind the group “Colorado Naloxone Project” started by doctors at the Swedish Medical Center. The project already has 47 hospitals, promising to dispense overdose antidotes when at-risk patients are discharged from the emergency department.
“It’s amazing to anyone who hasn’t seen the effects of naloxone,” said Dr. Don Stader, an emergency physician at Inglewood, Sweden. “It’s one of the most miraculous things in medicine. You see people who would really die come back to life.”
Officially launched on Monday, the goal of this project is to make Colorado the first state in the country to bring endangered patients home in Naloxone in all hospitals.
Delivered as an injectable and nasal spray, the drug was approved in the United States in 1971 to reverse overdose and has been distributed by overdose prevention organizations for decades. In Colorado, naloxone is available without a prescription at pharmacies and Denver needle exchange programs and the Harm Reduction Action Center, an addiction treatment institution.
Still, the emergency departments of many hospitals that use medications to save patients have only recently begun distributing naloxone for take-out, sometimes multiple times a day. Denver Health first devised such a protocol a few years ago, followed by Swedish.
In the last year or two, multiple hospitals across the state and four of Colorado’s largest hospital systems have joined the initiative. Several more hospitals have signed this week. The project is almost half of the goal, as the hospitals involved so far handle more than 50% of Colorado emergency room visits.
The initiative will soon launch a public awareness campaign, publish data on the results, and post a public dashboard listing which hospitals are attending. In addition to many hospitals in the Denver area, previous participants have included mountains. San Rafael Hospital in Trinidad, St. Vincent’s Hospital in Reedville, UC Health Yampa Valley Medical Center in Steamboat Springs, St. Mary’s Medical Center in Grand Junction. The main hospital systems involved are HealthONE, Centura Health, SCL Health and Denver Health.
— Fentanyl deaths have skyrocketed 524% since 2018
Pushes occur during the dire times of the opioid crisis.
Colorado is in the “third wave” of opioid epidemics caused by the astonishing surge in fentanyl that was illegally produced in Mexico and trafficked to the United States. A powder made from chemicals often imported from China, the drug is used to make counterfeit oxycodone and Xanax and is sold on the streets and on social media.
In Colorado, fentanyl-related overdose deaths increased by 524% between 2018 and 2020. In 2020 alone, 1,457 Colorado people died from drug overdose, according to preliminary data from the Colorado Department of Public Health and the Environment.
“We are at risk of the worst overdose we have ever seen in the United States, Colorado and Denver,” said Lisa Rabil, secretary-general of the Center for Harm Mitigation Action. “Fentanyl is here.”
According to Laville, people visiting the Harm Reduction Center for information on clean needles, treatment programs and naloxone used antidotes to save the lives of 83 people in March. She said that about 65% of those overdose reversals happened outside.
“We’re having a hard time, I’m not going to lie,” she said sitting in front of the memorial wall with pictures of people who died from overdose. “Sadness is becoming intolerable. When they reach the wall, it’s over.”
Senator Brittany Pettersen’s mother, Stacy Pettersen, said at a project event on Monday that Naloxone was the reason she was alive. “According to my daughter, my life was saved 20 times a year,” she said. “My memory is a little dark.”
Stacy Pettersen, who has recovered for four years, has been to the emergency department three times a day. She said she would now help others being treated for addiction and “live with my children and my grandchildren.”
Stader saved Pettersen’s life many times with the administration of naloxone.
A doctor at the Swedish Medical Center said his mission was “very simple. Let’s remove the barriers. Let’s get the life-saving medicine in your hands.”
Sold under the brand name Nalcan, the drug is safe to use and will not harm the patient if received when not overdose. “When we find that naloxone saves lives, it’s a damn time for us to start sending patients home with naloxone,” he said. “It’s funny that I haven’t done this before.”
Some of Colorado’s first take-away naloxone hospitals may be seeking funding for short-term naloxone programs through grants, even though they have not received refunds from insurance companies or Medicaid. was.
However, in 2020, Colorado General Assembly passed a law requiring insurance companies to reimburse hospitals for distributing drugs. The same law also required pharmacists to notify customers about naloxone when they received opioid prescriptions.
— Colorado pharmacies do not require a prescription
People have been able to get naloxone at Colorado pharmacies since 2015 without a prescription, after the state’s chief health officer created an “automatic transfer” that made it available to everyone. It offers medicines in hundreds of pharmacies throughout the state, primarily in the Denver area.
Still, stigma exists, especially in small towns where customers don’t want to ask local pharmacists for naloxone. And, according to research, many do not fill out prescriptions written by doctors.
HealthONE piloted the Naloxone project in 2018 with all emergency departments involved by last month. The drug is given not only to patients who come to the hospital because of an overdose, but also to patients who say they are using heroin or painkillers.
Centura signed all emergency departments and emergency medical centers in the system in September 2020. If the patient answers “yes” to any of the three screening questions, the hospital will dispense naloxone for take-out.
Doctor’s Question: Have you ever used illicit or prescription drugs for non-medical reasons? Have you ever used a prescription painkiller that is not yours? And are you worried about someone else who may have a problem?
Ultimately, Sader said hospitals want to administer naloxone not only from the emergency department, but from other departments, including surgery and obstetrics.
Just last week he treated a man who overdose while taking opioids to deal with a broken shoulder pain. The man’s wife noticed that he was unconscious and he was rushed to the Swedes.
He suffered brain damage because he had been out of oxygen for a long time.
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