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February 1, 2018

Narcan routinely saving Fauquier opioid users

Narcan nasal spray costs an average of $144 without insurance at seven Fauquier pharmacies surveyed recently.
First responders in Fauquier also sometimes use Naloxone, administered by syringe or IV. The U.S. Food and Drug Administration made the antidote publicly available in 2015.
Anytime you save someone, that’s a good thing.
— Sheriff’s Deputy 1st Class Aaron Vescovi
By Bennett Wise
FauquierNow Intern

Everybody agrees the powerful antidote to heroin and other opioid overdoses saves lives in Fauquier County.

First responders administered Narcan nasal spray or its active ingredient Naloxone 198 times last year in Fauquier, according fire/rescue and law enforcement authorities.

Nobody knows how often the antidote got administered by civilians.

While the number of overdoses increased in Fauquier last year, deaths attributed to drug use plummeted two-thirds. Drugs killed eight people in the county last year, compared to 22 in 2016, according to law enforcement officials.

Increased awareness, education and support groups may have helped reduce the number of deaths, Warrenton Police Chief Louis Battle said. But, Chief Battle and others also point to greater availability and training in the use of Narcan as potential factors in the dramatic decline of fatal overdoses.

“I can only imagine Narcan is the most important factor, because overdoses haven’t declined,” Mental Health Association of Fauquier County Executive Director Sallie Morgan said.

Reported drug overdoses rose 50 percent in Fauquier to 141 last year.

In November 2015, the U.S Food and Drug Administration approved Narcan for public distribution. Four months later, the first Naloxone-based nasal spray hit the market.

In the spring of 2016, the Fauquier sheriff’s office and Warrenton Police Department became among the first in Virginia to train and equip officers with Narcan. Almost immediately, they began saving lives in overdose cases.

Narcan, a nasal spray that contains Naloxone, reverses the effects of an opioid overdose. The antidote essentially gets between the drug and receptors in the brain. A dose of Naloxone prevents overdose symptoms for up to 45 minutes. But, opioids can stay in the bloodstream for several hours. Once the antidote wears off, the overdose symptoms may return.

When responding to suspected opioid overdoes, medics and police officers look for signs including:

• Blue or purple lips and fingertips.

• Shrinking pupils.

• Unconsciousness.

• Respiratory depression (slow or ineffective breathing).

Sometimes it requires another dose; Narcan doesn’t always work. First responders sometimes administer Narcan in cases that present themselves as overdoses but turn out to be something else. That use has no ill effect.

The antidote dates to 1971, but as the national opioid crisis has intensified, its use has grown far more common. And since mid-2015, Virginia has allowed its sale over the counter, without a prescription. Seven Fauquier pharmacies surveyed recently carry the antidote.

Without a prescription, those pharmacies charge an average of $144 for the Narcan spray, versus $36.36 for the Naloxone injection. Medics also administer it via IV.

Physicians often prescribe Naloxone in conjunction with pain medication in case a patient overdoses.

But, the over-the-counter cost can be daunting.

Travis Hale at the Remington Drug Co. said that because of the price his pharmacy fills “less than 40 percent of prescriptions for Narcan” its customers receive.

Insurance often covers the cost of a Narcan prescription, typically with a $20 to $40 patient copayment.

Some suggest that easy access to the lifesaving antidote can give illegal users a false sense of security.

Addicts can “use it as a crutch,” said a Fauquier sheriff’s undercover narcotics detective. “It perpetuates the problem.”

An addict might overdose and get Narcan “three, four or five times,” he added. “It could be higher, but we don’t know because of the easy access to Narcan.”

A physician who practices in the Fauquier Hospital emergency room acknowledges pros and cons of the antidote.

“Will it make people more careless? It’s possible,” Dr. Michael Jenks said. “But, I would rather save lives and send people to rehab than see them die.”

Some who use heroin or other opioids reject Narcan.

“Sometimes addicts, when we bring them back, say, ‘No Narcan,’ because it ruins their high,” sheriff’s Deputy 1st Class Aaron Vescovi said.

“But, anytime you save someone, that’s a good thing,” Deputy Vescovi added.

“It’s a lifesaving drug . . . but addicts will use anything as a safety net,” said Chris Connell, who manages the McShin Foundation’s peer-to-peer addiction recovery counseling program in Warrenton.

A recovering addict in McShin’s program, who spoke on the condition of anonymity, said she didn’t know about Narcan’s easy availability at pharmacies. The 15-year addict has received Narcan twice from first responders.

“Had I known about it, that’s exactly why I would have bought it,” she said.

To save lives, Ms. Connell recommends any family with a legal or illegal opiate user “have at least one dose of Narcan in their house.

“Every person needs to be trained; you never know when you will come across someone overdosing.”
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BJ · February 8, 2018 at 8:06 am
Trump Says He Will Focus On Opioid Law Enforcement, Not Treatment.
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