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Opioid crisis
- 1. Opioid Crisis Meghan Chasse University of Hartford NUR 621
- 2. What is the Opioid Epidemic? Roughly 27 million people suffer from opioid use disorders From 1999 to 2016 more than 600,000 people died from a drug related overdose In 2015, 118,000 individuals died from opioid use disorders High level of opioids can cause respiratory depression and death (World Health Organization, 2018) & (CDC, 2017)
- 3. (CDC, 2017)
- 6. What is Naloxone? Naloxone is a medication designed to reverse opioid overdoses Routes of administration: Intranasal or Intramuscular (NIH,2018) & (Faul, Lurie, Kinsman, Diley, Crabaugh & Sasser, (Rouge medic, 2018)
- 7. World Health Organization Naloxone be available to people who are likely to witness opioid overdoses Providing a large range of treatment choices for individuals that are suffering from opioid addiction Support countries to use medicine rationally (World Health Organization, 2018)
- 8. Bill No. 5053 An act concerning Opioids and access to overdose reversal agents “Each municipality shall amend its local emergency medical plan to ensure that first responders are equipped with Naloxone and receive training on administration” (Connecticut General Assembly, 2016)
- 9. Pros of Bill 5053 Ensure EMS have opioid overdose plans in place Prohibits prescribers from prescribing more than a seven days worth of opioids Allows healthcare professionals/bystanders to administer Opioid antagonist to treat or prevent and overdose without liability (Connecticut General Assembly, 2016)
- 10. Cons of Bill 5053 Lack of treatment options for those suffering with opioid addiction Lack of funding Lack of training to public on administering Naloxone (Connecticut General Assembly, (Nittyma, 2016)
- 11. Implications for Nursing Advocating for Naloxone kits Community nursing Collaboration with policymakers (Connecticut General Assembly, 2016) & (Green, 2017)
- 12. Summary Opioid addiction is an issue that is continuing to grow within the united states and the world More than 40 percent of all US opioid overdose deaths in 2016 involved prescription opioids. Bill 5053 works to ensure appropriate access to reversal agents (Green,2017, (CDC, 2017), & (Connecticut General Assembly, 2016)
- 13. References Centers of disease control (2017, August) Opioid overdose: Understanding the epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html Connecticut General Assembly. (2018). An act concerning opioids and access to reversal drugs. Retrieved from https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Public+ Act&which_year=2016&bill_num=43 Danaila, E. (2016, December 14). Hands medicine. [Photograph] Retrieved from https://pixabay.com/en/hands-one-medicinal-products-1903104/ Faul, M., Lurie, P., Kinsman, J.M., Dailey, M.W., Crabaugh, C., & Sasser S.M. (2017). Multiple naloxone administrations among emergency service providers in increasing. Prehospital Emergency Care, 21(4), 411-419. DOI: 101.1080/10903127.2017.1315203 Green, J. (2017). Epidemiology of opioid abuse and addiction. Journal of Emergency Nursing, 43(2), 106-113.
- 14. Reference National Institute of Drug Abuse (2018, April). Opioid overdose reversal with Naloxone. Retrieved from https://www.drugabuse.gov/related-topics/opioid- overdose-reversal-naloxone-narcan-evzio Nittyma, J. (2016, February 8). World map pills. [Photograph]. Retrieved from https://pixabay.com/en/world-map-pill-earth-healthcare-1185076/ World Health Organization (2018, August). Information sheet on opioid overdose. Retrieved from http://www.who.int/substance_abuse/information- sheet/en/
Editor's Notes
- Hello everyone. My name is Meghan Chasse. For my presentation I chose to look at the opioid crisis that is plaguing the country and world today, as well as legislation that is in place to attempt to fix the crisis. The opioid crisis is an important issues to the public and nursing.
- Opioid abuse is a growing public health problem. Opioids are psychoactive substances derived from the opium poppy. Examples in Heroin and Morphine More than half of those deaths involved opioids. On average 115 Americans dies every day from an opioid overdose Many of the individuals dependent on opioids use illicitly cultivated and manufactured heroin. Overdose deaths contribute to between one third to one half all drug related deaths
- The rise in opioid related deaths can be seen in three distinct waves. This image above is from the centers or disease control and shows the three waves. Wave one: Started in the 1990s. During this wave, the opioid deaths were related to prescription opioids Wave two: This wave stated in 2010. during this wave the opioid deaths were related to heroin Wave three began in 2013. During this wave the deaths are related to synthetics opioids.
- As you can see in this chart the rate of opioid related deaths in Connecticut are significantly on the rise. In comparison to the the US, Connecticut has spiked in the rate of Opioid related deaths. This shows that there is a need for increased access to Opioid reversal drugs such as Naloxone. Furthermore, this shows that there is also a need to prevention/recovery programs. Without proper prevention the trends will continue to rise.
- This chart shows opioid related deaths broken down by type of opioid involved. As you can see despite which type of opioid drug involved there has been a significant rise in opioid deaths from since 2000.
- Naloxone is an opioid antagonist—this means that it binds to the opioid receptors and can reverse or block the effects of opioids. it was originally approved by the FDA in 1971 it very quickly can restore normal respirations to an individual who has stopped breathing from an opioid overdose Naloxone can be given either IV, IN, or IM
- Also recommends that people receive training in managing an opioid crisis This includes psychosocial support, opioid maintenance treatment with methadone treatment, supported detoxification
- With the growing epidemic of opioid overdoses the department of HHS recognizes the need for increased access to effective overdose treatment and access to substance abuse programs to those who are addicted (Green, 2017). Bill 5053: An act concerning opioids and access to reversal agents works towards this. Bill no 5053 is concerned with opioids and the access to overdose reversal drugs, such as Naloxone (Narcan). This piece of legislation is from the Connecticut general assembly and pertains to CT. It was introduced in February of 2016 and was signed into law by the Governor in May 2016. The bill contains multiple provisions that related to opioid abuse prevention and treatment Bill 5053 ensures that health care professional (for example, a doctor) can prescribe Narcan, that emergency services have access to Narcan and proper training, and that any person in good faith with proper training can administer narcan without fear of violation.
- The first pro to Bill 5053 is that it required local cities and towns to amend their medical emergency plans to ensure that emergency medical responders had access to Naloxone and had proper training in the administration of Naloxone. Often times, first responders are the first people to arrive on scene when an individual experiences an overdose. It is essential they have proper training and plans in placed to provide life saving care. Another benefit to this bill is that is prohibits prescribers from prescribing more than 7 days worth of opioids. This allows them to follow up with the patient and ensure they are taking their medications appropriately and that their pain being managed. According to the CDC, taking opioids for a long period of time or at high dose can increase the risk for opioid use disorder and potential opioid overdose. It is important for prescribers to be aware of this an seek out alternative treatment options. Another pro to this bill is it allows bystanders to administer Naloxone without the fear of liability. Most itmes overdoses happen in the community setting, therefore it is essential for bystanders, friends or family members of individuals suffer with opioid addiction to have access and know how to administer Narcan. It can be life saving.
- One con of Bill 5053 is that it does not provide a definite treatment option for those suffering with opioid addiction. Providing Naloxone in an emergency is important however, there needs to be legislation and funding for treatment programs to help individuals recover from opioid addiction. The bill does require the creation of a council that looks into the substance abuse treatments/prevention programs. The bill estimates that municipalities would have to spend an estimated 10,000s dollars- this would include purchasing Naloxone and training employees. However, the bill does not give funding to municipalities. This could effect how much training municipalities provide to emergency responders or how many doses of Naloxone they can purchase. Bill 5053 allows any individual in good faith to administer naloxone to an individual suffering from an overdose, however the bill does not provide training programs to the public on how to administer the medication. It is essential that the public has appropriate training on how to administer Narcan so they can prevent more opioid related deaths
- The opioid crisis as an affect on nursing. Nurse’s are in a position to assess and education patients through evaluation and treatment. They are in a position to advocate for prescription or dispensing of Naloxone kits to patients and families who are at high risk to overdose (Green, 2017). Most times, opioid overdoses occur outside of the hospital in the community. Nurses see patients once they are brought into the ER by EMS. This bill ensures that first responders have knowledge on overdoses and how to properly treat them. Furthermore, this bill creates on council to look into treatment/prevention programs for patients/individuals suffering with opioid addiction. This will effect nursing working in the community. Nurse could potentially be running or working within programs that support patients recovering from opioid addiction.
- Treatment and prevention programs are essential to saving lives from opioid overdoses