ROCKINGHAM — All FirstHealth EMS ambulances starting today will carry nasal spray doses of naloxone or Narcan, the opioid overdose reversal drug, to be given to the families of overdose victims for personal use in case of emergency.
The state policy on providing nasal spray for personal use stipulates that the doses only be given if the victim refuses hospital treatment once they are revived, according to EMS Director Buddy Williams.
Prior to this change, a victim refusing further treatment would be taken into protective custody by law enforcement — interactions which Williams said often get “testy” because they are “not able to make rational decisions.” Providing personal doses and training on their usage is meant to increase safety of the victim regardless of what transpires immediately after being revived.
“We can’t give anybody a home-Narcan kit just because they ask,” he said.
Williams acknowledged that giving out personal doses of Narcan could lead those around the victim to not call for an ambulance in the event of an overdose.
“I hate to say it but that’s always a possibility.”
The North Carolina Office of Emergency Management Services asked FirstHealth EMS if it wanted to participate in this program in early January because of the increase in Narcan use in Richmond County. FirstHealth reported that 87 people were treated for overdose in the county in 2017, more than the previous two years combined.
The state office did not respond to a request for comment by press time Wednesday afternoon.
Emergency medical staff were trained Wednesday morning on the policy and how to use the devices that administer the doses — which are slightly different from what they normally carry — so they can train members of the household to administer it, according to Williams.
The nasal spray for personal use comes in boxes of two 4 milligram doses. Nasal spray was already being kept on ambulances as a backup to a saline lock — a miniature saline bag filled with naloxone, which is the fastest method of introducing naloxone into the bloodstream — in case they can’t use an IV, according to Williams. An intramuscular naloxone shot is the third option.
Williams said the stock EMS has been given will expire in August 2019 and it is unclear whether more will be provided after that point. FirstHealth EMS neither paid for nor applied for grants for the nasal spray doses, according to Williams.
The change comes after the Richmond County Board of Commissioners declared an opioid crisis at its February meeting and as health and law enforcement officials take steps to reverse the uptick in overdoses.
EMS doubled the Narcan stock that is kept on ambulances earlier this year because of the prevalence of more powerful synthetic opioids like fentanyl, which can be 10 to 100 times more powerful than heroin. These more powerful drugs require higher doses of Narcan to revive someone who has overdosed on them, forcing ambulances to refill their stocks more often.
Richmond County sheriff’s deputies have been equipped with Narcan for more than a year and used it to save three lives in 2017, according to Sheriff James Clemmons. Hamlet Police Chief Scott Waters said his officers have had Narcan for at least three months but have yet to use it.
Richmond County is ranked fourth in the state in opioid pills per resident at 132.2, according to statistics from the County Leadership Forum on Opioid Abuse, which is well above the state average of 78.3. The county’s rates of unintentional medication and drug overdose are also significantly higher than the state average at 18.8 deaths per 100,000 residents compared to 12.2 statewide, according to the N.C. State Center for Health Statistics.
Reach Gavin Stone at 910-817-2674 or [email protected]