Mercy Regional Medical Center is now providing take-home Naloxone kits, more commonly known as Narcan nasal spray, to those at high risk for opioid overdose.
Naloxone blocks the effects of opioids on the brain and can rapidly reverse an overdose. The nasal spray is reported to be 99% effective by Centura Health, the health care network that owns Mercy.
Liane Jollon, director of San Juan Basin Public Health, said the spray counteracts the depression of breathing that opioid overdoses cause.
The nasal spray comes in a pack with instructions, so if someone is experiencing an overdose and unconscious, a family member, friend or someone nearby can administer the Naloxone. The person experiencing an overdose typically regains consciousness within a few minutes.
People experiencing substance abuse disorder can go to a Mercy facility to make an appointment with a doctor for a prescription for the take-home Narcan. If someone is brought to the emergency room because of an overdose, patients are referred to a doctor if they want a kit to take home.
Patients are also referred to a rehabilitation clinic, Colorado Addiction Treatment Services.
“We want to be able to talk with people, let them know we are concerned about their safety and encourage them to seek out other treatments,” said Celeste Hanson-Weller, clinical nurse manager at Mercy.
The Naloxone spray is a temporary lifesaving measure, but Mercy also wants to address the bigger problem of lowering opioid addiction, she said.
The kit will be billed to the patient and their insurance.
The dose varies depending on the formulation, and sometimes more than one dose is needed to help the person start breathing again. Anyone who may have to use Naloxone should carefully read the package insert that comes with the product, according to the National Institute of Drug Abuse.
A kit typically expires after about a year.
The Narcan option for people experiencing substance abuse or substance abuse disorder, or the long-term abuse of drugs, comes as drug overdose deaths increase in Colorado with the coronavirus pandemic.
The Colorado Department of Public Health and Environment recorded 443 overdose deaths in the state between January and April 2020, a 35% increase from the same time period in 2019.
It is harder for people to seek long-term help and enroll in programs during a pandemic, Jollon said.
“When we adhere to social distancing, we see and work with each other less,” she said. “We don’t have the same awareness or vigilance to those who are suffering, which contributes to higher substance use and substance use disorder.”
Increasing access to Narcan is a short-term solution as health care facilities fill up with COVID-19 cases, Jollon said. But increased access to mental health care in Southwest Colorado would help in the long term, she said.
Hanson-Weller said the take-home Naloxone kits are part of an ongoing program, called Alternatives to Opioids, which started a couple of years ago to cut down opioid prescriptions from Centura Health facilities, and help people who already have an issue with opioids.
“This has been a hard time for a lot of people – our crisis services are used almost daily,” Hanson-Weller said.
But funding for substance use treatment and prevention services, along with behavioral and mental health services, was cut by $20 million in Colorado when tax revenue plummeted with the virus.
The state Office of Behavioral Health will receive a $41.6 million federal grant over the next two years to tackle the opioid crisis.
Overdoses in Southwest ColoradoJann Smith, La Plata County coroner, said she expected to see the number of overdose deaths rise with the start of the pandemic.
But La Plata County has seen only three overdose deaths since the start of January, she said.
But George Deavers, coroner for Montezuma County, said overdose cases are rising, if only slightly.
Seven people have died of an overdose since January in Montezuma County. Two additional people would have died from an overdose, but they died of something else, such as a heart attack, before the overdose killed them, Deavers said.
Four overdoses per year was the average in Montezuma County before 2015, and since then, the county has seen a spike with 11 in 2016 and a rise to about eight per year. About 50% of the overdoses in 2020 have been attributable to opioid drugs.
The Durango Police Department has used Narcan or seen Narcan used on calls eight times since the start of January.
“It’s definitely a lifesaver,” Cmdr. Rita Warfield with the Durango Police Department said.
The use of Narcan is not new, but it has been restricted in the past because of how much it costs, Warfield said. If patients have insurance, the out-of-pocket cost of Narcan will be lowered.
“It’s not a way to stop the drug problem overall, but it gives someone a second chance at life,” Warfield said.
Lt. Andy Brock with the Cortez Police Department said Cortez police officers have “administered Narcan that’s saved lives several times this year.”
“It’s a good game changer,” he said.
Colorado has seen an uptick in fentanyl use since the start of the pandemic, a powerful synthetic opioid typically used to treat patients with severe pain.
“Higher fentanyl levels lead to higher numbers of overdoses,” Brock said.
Mancos Marshal Justen Goodall said most illegal narcotic users already carry nasal Narcan spray when using substances like fentanyl and heroin.
“It’s important for people to know that if you stay on scene and report the overdose, you can’t be charged in the state of Colorado,” Goodall said. And if calling in or using Narcan spray saves a person’s life, it is not common for people who report an overdose to be charged federally.
And under Colorado Senate Bill 217, an overdose is not a crime unless there was forcible usage of the substance, Goodall said.