By Nadia Kounang,
As the opioid overdose epidemic continues to surge, public health officials and first responders have turned to naloxone, the drug that reverses overdose, to help combat the rising tide. New research from Brigham and Women’s hospital in Boston shows its effectiveness.
A review of emergency medical services data from Massachusetts found that when given naloxone, 93.5% of people survived their overdose. The research looked at more than 12,000 dosages administered between July 1, 2013 and December 31, 2015. A year after their overdose, 84.3% of those who had been given the reversal drug were still alive.
‘We saved them’
“With this reversal agent, we’re saving the vast majority of people,” said Dr. Scott Weiner, lead author of the study and an emergency physician at Brigham and Women’s Hospital. “These are people who got naloxone by ambulance. So we saved them. The lesson learned is not that naloxone is failing; it’s working.”
But it also means that once saved from an overdose by EMS, a patient had about a 1 in 10 chance of not surviving a year. About 35% of those who were dead a year later died of an opioid overdose. And that should be a concern, Weiner said: “It doesn’t treat the underlying problem.”
The findings are being presented Monday at the American College of Emergency Physicians‘ annual conference in Washington.
In 2014, only 12 states allowed basic EMS staff to administer naloxone for overdose. Today, laws in every state allow the drug to be administered by anyone, from a physician to a family member.
Dr. Sharon Stancliff, an expert on opioid overdose prevention, said that although it has long been known that naloxone is effective at keeping people alive, it was the first time she recalled seeing such specific numbers regarding its effectiveness.
“It’s really important data, and there’s a lot we can do with it,” said Stancliff, medical director of the nonprofit Harm Reduction Coalition, who was not involved with the research.
Emergency departments fight back
According to the US Centers for Disease Control and Prevention, last year alone, there were an estimated 64,000 fatal drug overdoses, most of them from opioids. And for each fatal overdose, there are approximately 30 nonfatal overdoses — many of the cases appearing in emergency rooms across the country. In fact, between 2005 and 2014, the rate of opioid-related emergency visits increased by 99.4%.
Stancliff believes that these hard numbers could be used to help persuade emergency rooms to change how they handle overdoses.
Weiner agreed and said the next steps on what to do with a patient are key in helping stop the drug overdose crisis. In emergency rooms, once people recover from an overdose, they may be given a list of phone numbers for treatment centers but not much else.
It is important to get people “engaged in treatment as soon as possible,” he said. A number of innovative emergency departments are working toward this, whether by bringing recovery specialists into the emergency room or even by having treatment facilities nearby.
“Some of the ERs in New York are really jumping on it, starting people on buprenorphine,” a medication used to help wean people off opioids, Stancliff said.
Weiner hopes that these data can be used to help persuade clinicians to figure out the next steps — and persuade patients to take those steps.
“If I’m taking care of a patient in the ED, I want to be able to tell them what the real chances of dying are if they continue using. I can look them in the eye and say, ‘you have a 1 in 10 chance of dying in a year if we don’t get you treated,’ and I think that’s really powerful,” Weiner said.
There is no chemical cure to this epidemic. Recovery involves changing everything; substance use is but a symptom of the underlying brain disorder of those born with the addiction genetic profile. Reliance on one facet of a multi-faceted disease such as addiction is doomed to failure. Buprenorphine is a great step to replace the traditional opiates such as fentanyl, heroin and others.
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