Author: rbuckman

County Health Department Naloxone Program Overview

Prepared for (school name)

Date

Overview: The County Health Department was awarded (# of) Nasal Naloxone Rescue Kits through a grant from the Indiana State Department of Health. The goal of this program is to provide free nasal Naloxone to County laypersons who are at risk of experiencing an opioid overdose, or to other individuals or entities in a position to assist an individual, who, there is reason to believe, is at risk of experiencing an overdose. Indiana Code 16-42-27 allows for local Health Departments to operate under a standing order to train laypersons how to use Naloxone.
Aside from training laypersons in close contact with someone struggling with addiction, the health department is also seeking to train community organizations and agencies working with higher risk populations. In our grant proposal we wrote that we would approach high school and middle school nurses about having Naloxone in their clinics, motels/hotels who have residents who are at risk, and other various community agencies and businesses working with higher risk populations. (Insert appropriate information for your department)
In order to receive training, a layperson must contact the Health Department to set up a training appointment with the Public Health Education Specialist. Training appointments are 15-20 minutes long. Larger scale on site trainings for community agencies and businesses are also available. (Insert appropriate training information for your department)
Training Requirements:
The training for these laypersons follows all guidelines from IC 16-42-27, also known as Aaron’s Law. All participants must accept the following by signing their name:
I affirm that I am a person at risk of experiencing an opioid-related overdose or that I am a family member, friend, or other individual or entity in a position to assist an individual who, there is reason to believe, is at risk of experiencing an opioid-related overdose.
I affirm that I have received Naloxone Rescue Kit Training, covering how to recognize an opioid overdose and how to respond to and treat an overdose, including how to administer the naloxone rescue kit.
I understand I must contact emergency services (911) immediately after administering naloxone.
I affirm that I was provided drug addiction treatment information and referrals to drug treatment programs, including programs in the local area and programs that offer medication assisted treatment that includes a federal Food and Drug Administration approved long-acting, non-addictive medication for the treatment of opioid or alcohol dependence.
I understand I cannot resell the naloxone rescue kit(s) provided to me by the Hendricks County Health Department.
I agree to report a naloxone rescue kit’s use (after the emergency has passed) by filling out and mailing the pre-paid postcard survey included in the kit.
I acknowledge that I have been given the opportunity to review Indiana Code 16-42-27, Drugs: Overdose Intervention Drugs, which outlines my responsibilities as a lay responder, before signing.
Participants who do not agree to these statements will not receive a kit. The drug addiction treatment resources include (list resources given) . The pre-paid survey refers to a survey provided by the Indiana State Department of Health included in the kits.

About Addiction:
Addiction is considered a brain disease due to how drugs change the brain structure and how it functions. These brain changes can be long-lasting, and can lead to the harmful behaviors seen in people who have a substance use disorder.
A person does not choose to become an addict, the person's body responds differently when exposed to alcohol and drugs. Being addicted to alcohol or drugs does not make a person flawed or wrong. Similar to other chronic diseases, users need regular care, attention, and treatment (Overdose Lifeline).
Data:
The opioid epidemic affects every state, county, socio-economic and ethnic group. Indiana ranks 15th in the nation for drug overdose deaths – and was one of 14 states that had significant increases over recent years (Overdose Lifeline).
In 2015, 2.4% of high school students in Indiana reported having tried heroin at least once, according to the 2015 Youth Risk Behavior Surveillance System (YRBSS). Additionally, 1.8% of 8th grade students, 3.7% of 10th grade students, and 5.8% of 12th grade students indicated current misuse of prescription drugs (Indiana Youth Survey, 2016). (Insert your county’s data)
During 2016, (#) opioid overdoses were reported in County based on area hospital emergency department data. Of these, the (town/city) zip code (#####) had the most reported overdoses with (#) occurring in 2016. (Use the town and zip code of the school district)
Additionally, county death records show that (#) opioid overdose deaths occurred in zip code between (date) , and (date) ; (#) of these deaths occurred between 2016-now. (This helps show that the issue is significant and increasing)
County Health Department Naloxone:
There are multiple ways to administer Naloxone,
including intranasally, intramuscularly, and intravenously.
The Health Department currently has Narcan, a brand
name nasal spray form of administration.
This nasal spray is effective and easy to use.
Why Carry Narcan?
Narcan is proven to be a safe and effective way to reverse potentially deadly opioid overdoses
Same concept as AED’s and EpiPens
Safe to use even if the person has not had an overdose- Naloxone will not affect someone who is not having an overdose
Easy to administer
No potential for abuse

FAQ’s:
Can Naloxone make someone violent upon waking up?
In someone who has been using opioids regularly, opioid withdrawal symptoms can happen after receiving naloxone and may include: body aches, diarrhea, increased heart rate, goose bumps, sweating, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, stomach cramping, weakness, and increase blood pressure. There is a small chance of violence occurring due to the unpleasant withdraw symptoms, but according to Overdose Lifeline this happens less than 3% of the time. It’s important to note that if this happened, EMS would likely already be on the scene.
Is there anyone who shouldn’t have Naloxone?
Anyone who is breastfeeding or pregnant should not have Naloxone. Additionally, anyone with the following rare allergies should not be administered Naloxone.
Naloxone hydrochloride, benzalkonium chloride (preservative), disodium ethylenedia minetetraacetate (stabilizer), sodium chloride, and hydrochloric acid
Does Naloxone enable drug users to continue use?
Research has shown that Naloxone does not enable users to use more. In fact, if anything, it decreases the use of opioids. Some argue that users will use Naloxone as a back up plan to save themselves, but users know that Naloxone will take away the high they are seeking. Therefore, Naloxone does not enable/encourage them to use more. However, we do still encourage schools not to advertise that they have Naloxone on hand. Overall, we recognize that Naloxone does not cure the disease of addiction, but it does give users a second chance at life and recovery.
Additional Information:
# kits have already been given to laypersons throughout County.
Those who have already been trained include family members with a loved one struggling with addiction and community organizations and businesses who are working with at risk populations, including school nurses. (# of) school corporations in our county have trained nurses at this time. (These points help show this is a community collaboration effort and that others are getting involved)
Have any questions? Contact (your Naloxone program leader) at email or (###) ###-####. Thank you! (Insert your Department’s information below)