This document summarizes a clinical skills workshop on overdose prevention and response through administering naloxone. It provides statistics showing the rise in overdose deaths from prescription drugs and heroin in the US. It describes who is at risk of overdose and when naloxone should be prescribed. The workshop reviews videos demonstrating naloxone administration and discusses how distributing naloxone saves lives without enabling drug use. Over 150,000 laypeople have been trained to reverse over 26,000 overdoses. The workshop encourages participants to educate others on naloxone and reducing overdose risk.

1. Clinical Skills
Workshop:
Overdose Prevention and Response —
Administering Naloxone to Save Lives
POPULATION HEALTH INTEREST GROUP
SEPTEMBER 8, 2016

2. Conflict of Interest Disclaimer
 No financial disclosures.
 Adapt Pharma provided one trainer of its nasal spray (no medicine) for
demonstration.
 Kaleo provided Evzio autoinjectable trainers (no medicine) for
demonstration.

4. How bad is it?

5. National Overdose Deaths
Number of Deaths from Prescription Drugs
0
5,000
10,000
15,000
20,000
25,000
30,000 Total Female Male
Source: National Center for Health Statistics, CDC Wonder

6. National Overdose Deaths
Number of Deaths from Prescription Opioid Pain Relievers
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000 Total Female Male
Source: National Center for Health Statistics, CDC Wonder

7. National Overdose Deaths
Number of Deaths from Heroin
0
2,000
4,000
6,000
8,000
10,000
12,000 Total Female Male

8. Whom are we talking about?

9. Break for video #1

11. It’s more than “use as directed”
An adverse reaction can occur if:
 Co-morbidities: lungs, liver, kidneys, etc.
 Co-pharmacy: e.g. sedative
 Genetic susceptibility
 Drinking alcohol
 User error
 Period of abstinence
 Switching opioids
 Family member may help themselves

13. When to write a script
 If patient is prescribed an opioid medication.
 If patient is using opioids of any kind.
 After a period of abstinence (any kind, including incarceration or drug
treatment).
 If pt. has experienced an overdose or adverse reaction.
 If pt. has witnessed an overdose or adverse reaction.
 If pt. asks for it.
 If pt. has a household member who might benefit from it.

15. Break for video #2

17. Enabling? No!
Safe? Yes!
• Been around since 1961
• Communities have been distributing
since 1996
• No compensatory behavior since it
causes withdrawal.
• No potential for abuse.
• People use it.
• Leads to treatment for substance
use disorder.
• Decrease in deaths much greater
than amount supplied, indicating
decrease in risky behavior as result
of the educational process that is
part of providing rx.

18. Si se puede!
 150K laypersons trained.
 26K OD reversed .
 80% of reversals were
performed by drug users
 In North Carolina, their
three-year-old program
has had 4,000 reversals.
 FDA working on making it
OTC.
 FDA changing labels on all
opiates and benzos.

19. Rx, OTC, Standing Order

20. To script or not to script
 There may not be a standing order in your state.
 Standing order may only be for certain pharmacies.
 Pharmacist may not be aware of standing order.
 Patient may not know to ask for it.
 Patient may not remember to ask for it.
 Easier to pick up all rx at once.
 Less worry about payment and billing issues.
 There is no downside to writing a script.

21. Your new best friend:
www.prescribetoprevent.org
One-stop shopping for patients, advocates, prescribers, pharmacists: videos,
online CME, research, legal info, billing, Rx pads, and things you never thought
you might need.
 Where do we go from here?
 Train your classmates: this is an easy brown-bag lunch session.
 Show video(s)
 Give demo
 Tell people where to get it for themselves
 Make this a national AMSA Project, educating medical students, college
students, incarcerated populations, drug treatment programs, faith
communities, etc.

22. Thank you!
Mary Beth Levin, MPH
Associate Professor
Department of Family Medicine
Georgetown University School of Medicine
levinmb@gmail.com
Other resources:
Harm Reduction Coalition: www.harmreduction.org
North Carolina Harm Reduction Coalition: www.nchrc.org
Chicago Recovery Alliance: www.anypoisitivechange.org