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.
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
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
12.
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.
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.
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
Editor's Notes
National Overdose Deaths—Number of Deaths from Prescription Drugs. The figure above is a bar chart showing the total number of U.S. overdose deaths involving prescription drugs from 2001 to 2014. The chart is overlayed by a line graph showing the number of deaths by females and males. From 2001 to 2014 there was a 2.8-fold increase in the total number of deaths.
National Overdose Deaths—Number of Deaths from Prescription Opioid Pain Relievers. The figure above is a bar chart showing the total number of U.S. overdose deaths involving opioid pain relievers from 2001 to 2014. The chart is overlayed by a line graph showing the number of deaths by females and males. From 2001 to 2014 there was a 3.4-fold increase in the total number of deaths.
National Overdose Deaths—Number of Deaths from Heroin. The figure above is a bar chart showing the total number of U.S. overdose deaths involving heroin from 2001 to 2014. The chart is overlayed by a line graph showing the number of deaths by females and males. From 2001 to 2014 there was a 6-fold increase in the total number of deaths.
