In the United States there has been a significant increase in deaths resulting from prescription opioids (painkillers) and heroin.
WHAT ARE OPIOIDS? Opioids include illegal drugs such as heroin, as well as prescription medications used to treat pain such as morphine, codeine, methadone, oxycodone (OxyContin®, Percodan®, Percocet®) hydrocodone (Vicodin®, Lortab®, Norco®) fentanyl (prescription and illicit), hydromorphone (Dilaudid®, Exalgo®) and buprenorphine (Subutex®).
Overdose deaths were the leading cause of accidental deaths, surpassing motor vehicle crashes.
North Carolina is not immune to this epidemic and it continues to spread. In Forsyth County alone, opioid overdose deaths have increased by 960% from 1999-2015.
North Carolina and Forsyth County are addressing this opioid epidemic head on. This page offers information for community members, pharmacists, first responders and healthcare professionals who can help us confront this public health crisis.
THE U.S. OPIOID EPIDEMIC
More than 91 Americans die each day from an opioid overdose. Since 1999 overdose deaths quadrupled with over 500,000 lives lost. 2015 claimed more deaths from overdose than any other year in history.
Overdose is not the only risk related to prescription opioids. Misuse, abuse and opioid use disorder (addiction) are also potential dangers.
● In 2014 almost 2 million Americans abused or were dependant on prescription opioids.
● As many as 1 in 4 people who receive prescription opioids for noncancer pain in primary care settings, struggle with addiction.
●Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.
WHAT IS NALOXONE?
Naloxone is a prescription medicine that reverses an opioid overdose. Opioids include heroin and prescription medications such as oxycodone and hyrocodone.
Naloxone will only reverse an opioid overdose, it does not prevent deaths caused by other drugs such as benzodiazepines (e.g. Xanax®, Klonopin® and Valium®), bath salts, cocaine,methamphetamine or alcohol.
Naloxone is safe and effective, medical professionals have been using it for decades.
Naloxone is also known as Narcan®. Narcan® is the brand name of Naloxone and it is administered intranasally.
How does Naloxone work?
Naloxone is an antidote for opioid medications. Opioids can slow or stop a person’s breathing, which can lead to death. Naloxone helps the person wake up and continue breathing.
An overdose death may happen hours after taking drugs. If a bystander acts when first noticing a person's breathing has slowed, or will not wake up, it is time to call 911 and start rescue breathing (if needed) and administer Naloxone.
Increasing Naloxone Access in North Carolina
In June, 2016, the State Health Director of North Carolina signed a standing order (statewide prescription) to authorize any pharmacist practicing in the State and licensed by the North Carolina Board of Pharmacy to dispense Naloxone to any person who voluntarily requests Naloxone and is:
1. At risk of experiencing an opiate related overdose.
2. A family member or friend of a person at risk of experiencing an opiate related overdose.
3. In the position to assist a person at risk of experiencing an opiate related overdose.
How am I protected if I administer Naloxone?
Effective April, 2013, the Good Samaritan Law began protecting lay people in North Carolina who are able to access, carry and administer Naloxone to reverse the effects of an opioid overdose. North Carolina's Good Samaritan Law (State Bill 20) provides immunity from civil and criminal liability for people who administer or dispense Naloxone.
This means you are protected by the law in North Carolina if you give Naloxone to someone who is having an overdose. If, in good faith, you think the person is having a drug overdose and you use reasonable care to give the Naloxone, you are protected from a lawsuit for giving the person Naloxone.
On August 1, 2015 Clarifying the Good Samaritan Law (State Bill 154) was signed. The law states that a person who seeks medical assistance for someone experiencing a drug overdose cannot be considered in violation of a condition of parole, probation, or post-release, even if that person was arrested. The victim is also protected. The caller must provide his/her name to 911 or law enforcement to qualify for the immunity.
The Good Samaritan Law means it's OK to call 911 for a drug overdose. You won't be prosecuted for small amounts of drugs or paraphernalia or underage drinking.
The Stop Act of 2017 was introduced into legislation on March 2, 2017 and is sponsored by Representatives Murphy, Davis and Horn and Senators Davis, McInnis and Rabon.
Below find key components of the proposed Stop Act of 2017:
Reduce doctor shopping and improve care with required check of state prescription database.
Before prescribing controlled substances, a doctor, dentist, or other prescriber must check the Controlled Substance Reporting System (CSRS) to learn of a patient's other prescriptions. This check is allowed but not required for cancer treatment, palliative care, hospice care, drugs administered in a health care or residential facility, or prescriptions for 5 or fewer days (or 7 or fewer days after surgery)
Reduce unused, misused, and diverted pills with a 5-day limit on initial prescriptions for acute pain.
A prescriber may not prescribe more than a 5-day supply of a controlled substance (or a 7-day supply after surgery) when first treating a patient for acute pain. This requirement does not apply to cancer care, palliative care, hospice care, or medication-assisted treatment for substance use disorders.
Reduce fraud through e-prescribing. A prescriber must electronically prescribe controlled substances to reduce fraud stemming from stolen prescription pads or forged prescriptions - except for drugs to reduce fraud stemming from stolen prescription pads or forged prescriptions - except for drugs administered by the prescriber or drugs administered in a health care or residential facility.
Reduce diversion of veterinary drugs. Veterinarians who prescribe controlled substances must register and report to CSRS to enable detection of drug diversion by pet owners.
Tighter supervision. Physician assistants and nurse practitioners must consult their supervising physicians the first time they prescribe controlled substances and every 90 days thereafer.
Stronger oversight. The Department of Health & Human Services will audit doctor, dentist, and other prescriber use of CSRS and report violations to appropriate licensing boards.
Better data use. The Act expands use of data to detect and prevent fraud and misuse.
More secure funding. The Act creates a fund to support CSRS with an annual fee on prescribers.
Universal registration and reporting. All pharmacies dispensing controlled substances must register for and report to CSRS - consistent with the current practice of most pharmacies.
Near-time reporting to detect and stop doctor-shopping. Pharmacies dispensing controlled substances must report to CSRS within 24 hours of each transaction - down from the current requirement of 72 hours but consistent with the current practice of many pharmacies.
Detect fraud, misuse and diversion. Pharmacies must consult the CSRS before dispensing a controlled substance when there is a reason to suspect fraud, misuse or diversion and consult the prescriber when there is reason to believe the prescription is fraudulent or duplicative.
Better data. Pharmacies are required to remedy missing or incomplete data upon request.
A RENEWED COMMITMENT TO TREATMENT, RECOVERY AND SAVING LIVES:
Improve health and save money by investing in local treatment and recovery services. The Act appropriates $10 million for FY 2017-2018 and $10 million for FY 2018-2019 for community based treatment and recovery services for substance use disorders, including medication-assisted treatment.
Reverse overdoses and save lives. The Act facilitates wider distribution of the overdose-reversal drug naloxone by clarifying that standing orders cover not only individuals at risk, family members, law enforcement, and local health departments but also community health groups. In addition, the Act underscores that no state funds may be used to support needle exchange programs but does not preclude a local government from supporting such a program in its community.
When was the last time you cleaned out your medicine cabinet?
You may not even realize that you have uneeded, expired or recalled products in your medicine cabinet. Leaving expired and unused drugs "just in case" can put anyone in your home, including children and pets, at risk for accidental ingestion, misuse or overdose. So it's time to take action. Protect your family and clean it out!