FEATURE
STATISTICALLY SIGNIFICANT DRUG OVERDOSE DEATH RATE INCREASE FROM 2014 TO 2015, US STATES
https://www.cdc.gov/drugoverdose/data/statedeaths.html
for up to 36 hours. Suboxone (buprenorphine and naloxone)
prevents the high if the addicted person were to use a narcotic;
but it will not provide pain relief. Once a person is completely
detoxified, maintenance may be achieved with the use of Vivi-
trol (Naltrexone) by reducing the urge to use drugs or alcohol.
Naltrexone has the advantage of being offered in an injection
on a monthly basis.
3. PUBLIC ACCESS TO LIFE-SAVING NALOXONE
Hospitals have carried naloxone (Narcan, Evizo) for years to
reverse the respiratory depressant effects of narcotics. With
the rise of opioid addiction, especially with fentanyl and other
highly potent street drugs, the number of deaths from respi-
ratory depression has so dramatically escalated that now first
responders and police officers generally carry doses of injectable
Evizo or intranasal Narcan. Designated family members of
known drug addicts are often allowed to keep these drugs for
emergencies. Legislation is being sought to make these drugs
publicly available in the same fashion as Automated External
Defibrillators (AED) are found in public places. Additionally,
greater insurance coverage for both pharmaceuticals used in
maintenance programs and for naloxone is being sought at
both state and federal levels.
The control of the current opioid epidemic is not simple. It is
not just a physician’s problem. It’s one in which doctors must
play a significant role on the educational, prescribing and
treatment fronts.
12
LOUISVILLE MEDICINE
Dr. James is the Senior Medical Director for Highmark Inc. in Pitts-
burgh, PA.
References:
1.) Centers for Disease Control, The Opioid Crisis, https://www.cdc.gov/
drugoverdose/data/statedeaths.html (Last accessed Nov. 24, 2017)
2.) National Institute on Drug Abuse, National Institutes of Health. Addiction
Science. https://www.drugabuse.gov/related-topics/addiction-science
(Last accessed Nov. 24, 2017)
3.) Maya Salam, The Opioid Epidemic: A crisis years in the making. The
New York Times, Oct. 26, 2017
4.) Jena AB, Barnett, Goldman D, How health care providers can help end
the over prescription of opioids. Harvard Business Review Oct. 24, 2017
5.)
Volkow ND, McLellan T, Opioid abuse in chronic pain — Miscon-
ceptions and mitigation strategies. N Engl J Med 2016; 374:1253-1263,
March 31, 2016.