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‘Save A Life Day’ Spreads Support, Naloxone Across The State

West Virginians will be out and about in every corner of the state Thursday in an effort to educate their neighbors and hand out overdose-reversing tools with one goal in mind: Save a Life.

Sept. 8 is Save a Life Day in West Virginia.

West Virginians will be out and about in every corner of the state today in an effort to educate their neighbors and hand out tools with one goal in mind: Save a Life.

“The official name for this day is ‘Save a Life Free Naloxone Day’,” said Joe Solomon, the co-director of Solutions Oriented Addiction Response West Virginia (SOAR). “This September 8 anyone can pick up Narcan in all of West Virginia’s 55 counties at over 180 locations.”

Save a Life Day started out with just two counties in 2020, at the height of the pandemic. But in just two years Save a Life Day has established a presence in all 55 counties.

Solomon’s organization helped spread the event across the state in an effort to get the overdose-reversing drug naloxone into as many hands as possible.

“Naloxone was approved by the FDA 51 years ago,” Solomon said. “The way it works is very simple. It pops off the opioid receptors in your brain and pops them off from the opioid if your brain is flooded with opioids. It allows someone’s breathing to come back online. And that allows their consciousness in turn to come back online.”

Naloxone is a keystone of Save a Life Day because having it readily available can be a literal life changer in a state that Solomon calls ground zero of the opioid crisis.

“In all 55 counties, people want to do something to stop their families and their neighbors from losing loved ones,” Solomon said. “Free Narcan day’s a chance for people to say, ‘Hey, I want you to live, hey, you’re important to our community. Hey, I want you to get through this day, I want you to know that I love you.’”

Naloxone is not the only thing on offer during Save a Life Day. Volunteers and workers also offer education on how to use the medicine, as well as information about local addiction and recovery resources.

Perhaps the most important thing available during Save a Life Day are open minds and a lack of judgment.

Brittany Irick is the coordinator for Monongalia County’s Quick Response Team. Her team works to be on-site after a drug overdose to offer support and resources to those affected.

“Instead of stigmatizing those people who make that choice, let’s give them the tool to prevent a death,” Irick said. “Nobody wakes up and says I want to become addicted to drugs today, I throw my life away. And when people hear that message, I think that it really changes their perspective.”

She points out that overdoses do not discriminate and they are not restricted to substance users.

“As we’ve seen an uptick in fentanyl in pretty much everything all across the state all across the U.S., we’ve realized how important it is to get more Narcan out into the community,” Irick said. “Not just for people who are in active substance use but like college kids, even high school kids.”

Discussions of substance abuse and overdose can get grim at times but in speaking to the people involved in Save a Life Day, there is a palpable energy and excitement to see the event touch every community in the state.

“I’m a little bit partial to helping my state because I think it’s beautiful and full of amazing people,” Irick said. “The fact that all 55 counties are coming together to promote this message like this, this is how we get past this. This is how we get past the drug epidemic.”

There’s a saying in addiction recovery circles: You can’t recover if you’re dead.

Some communities are looking at the longer-term impacts of Save a Life Day. In Logan County, to cap off the day’s activities, organizers like Barb Ellis are preparing for a Recovery Parade to close out the day.

“Once you find recovery, you want recovery for anybody and everybody else,” Ellis said.

Ellis is a peer recovery support specialist for Mountain Laurel Integrated Health Care. She says the day isn’t about one organization or individual, it’s about the community coming together to support each other and address the issue of overdoses together.

“We’re going to be doing a recovery walk,” Ellis said. “We’re asking anybody who is in recovery in our county, or anybody who is a family member of somebody who’s in recovery – because we all know that addiction is an individual thing, it’s a family problem – come walk with them.”

Fellow Logan County recovery specialist and QRT program manager John Kangas says visibility is a powerful tool.

“Being able to have, whether it’s five people, 25 people, 50 people out there walk in the streets, that helps break down the stigma,” Kangas said. “They’ll see these people on the sidelines, will see us walking, “Hey, I know him or I know her. I didn’t know they were in recovery. Holy crap.” Yeah. I mean, we’re everywhere.”

Wherever you are in West Virginia today, be on the lookout for a Save a Life Day event in your community.

Overdose Deaths Up, Experts Say ‘Co-Prescribing’ Could Help

Overdose deaths are significantly rising in many states including West Virginia, but some are now adopting new laws that require those with opioid addictions to receive a reversal agent like Narcan alongside their pain medication prescription. This tactic would serve as a way to help save lives, should a patient overdose.

The Centers for Disease Control and Prevention released data Thursday showing a 10 percent rise in fatal overdoses in the first three months of this year compared to last. West Virginia saw 67 more deaths by March compared to 2019, and according to the CDC, this data is underreported.

The American Medical Association has released similar reports linking the fatal overdose increases to the pandemic, as more people are alone and depression and anxiety are on the rise — factors that can inhibit recovery.

Naloxone, an opioid overdose reversal agent, has been proven to slow the rates of overdose deaths. Starting in 2017 with Virginia and Vermont, 10 states have “required co-prescribing rules,” including New Jersey most recently.

“Opioids continue to be prescribed to patients for chronic pain,” said Ben Atkins, director of communications for Opiant Pharmaceuticals, the company that developed Narcan — a Naloxone nasal spray. “And what co-prescribing means is that when a prescription is given to a patient for an opioid, you also co-prescribe a reversal agent.”

A co-prescription of Naloxone is considered a preventative measure, in the case the patient were to overdose. Atkins said one in three patients prescribed an opiate are at risk of developing an addiction.

“It’s not just the access to the medication itself,” he said. “It’s all sort of touchpoints between the doctor and the patient to talk about the potential risks of an opioid medication.”

West Virginia has legislation supporting co-prescribing, but not requiring it. However, lawmakers have discussed introducing legislation in the near future.

In Opioid Epidemic, Some Cities Strain To Afford Overdose Antidote

On a Baltimore street corner, public health workers hand out a life-saving overdose antidote to residents painfully familiar with the ravages of America’s opioid epidemic. But the training wraps up quickly; all the naloxone inhalers are claimed within 20 minutes.

“We could’ve easily handed out hundreds of doses today. But we only had 24 kits. That goes fast,” said Kelleigh Eastman, a health department worker assisting the city’s bluntly dubbed “Don’t Die” anti-overdose campaign.

Cities like Baltimore are feeling the financial squeeze as they rely on naloxone to try and counteract rising overdose rates. Some hard-hit communities across the country are struggling to pay for dosages even at reduced prices.

With more overdoses driven by synthetic opioids like fentanyl and carfentanil — so potent it’s used as an elephant tranquilizer — naloxone remains pricy enough that Baltimore’s health department is rationing supplies, stretching a dwindling stockpile of inhalers. Last year, the city distributed more than 25,000 doses, up from about 19,000 in 2016.

“Every week, we count the doses we have left and make hard decisions about who will receive the medication and who will have to go without,” said Baltimore Health Commissioner Dr. Leana Wen, who issued the city’s innovative blanket prescription for the drug in 2015.

Numerous states have since passed laws — including bypassing prescription requirements and establishing community training programs — aimed at expanding use of the medication that restores a person’s breathing while temporarily blocking the brain’s opioid receptors.

“It’s a bit of a pressure-cooker environment for Baltimore but also places in many other states that have been on the front lines of the overdose crisis and where the toll keeps rising. The challenge, on a structural level, is that there’s no clear sustainable funding source for naloxone,” according to Daniel Raymond, policy director for the National Harm Reduction Coalition.

In Charleston, West Virginia, the health department reported Monday that it has only 159 doses remaining, most allocated for community classes in coming days. Kanawha-Charlestown Health Department spokesman John Law said they’ve requested more naloxone auto-injectors from the company that’s donated to them in the past “but we have had no response.”

Last week, U.S. Surgeon General Dr. Jerome Adams issued the office’s first national public health advisory in 13 years, calling on more Americans to start carrying naloxone and urging more federal funds be dedicated to increasing local antidote access.

“Costs should not and, in the near future, will not be a barrier to accessing naloxone for anyone in America,” Adams pledged.

A two-dose carton of Narcan — a brand name for naloxone inhalers — has list prices of about $125. First responders and community organizations can purchase Narcan at discounts of $75 per two-dose carton, according to manufacturer Adapt Pharma. The Evzio auto-injector from Virginia-based drugmaker Kaleo currently has list prices of roughly $3,800 for a box with two doses, up from about $690 in 2014. Last week, Kaleo announced a new initiative that will allow federal and state government agencies to make direct purchases of two-pack Evzio kits for $360 each.

The surgeon general’s advisory was welcome in Philadelphia, where health officials have debated internally whether “rationing” accurately describes their naloxone situation. The city has one of the highest opioid death rates of any large U.S. metropolis and distributed 25,000 doses from July through December last year.

“Given the tremendous scope of the opioid epidemic and (our) anticipated 1,200 overdoses deaths in 2017, easier — and cheaper — access to naloxone for the general public and public safety agencies has the potential to save hundreds of lives,” Philadelphia Health Department spokesman James Garrow said.

The stakes couldn’t be higher. Growing anecdotal evidence shows that multiple naloxone doses are needed to reverse an overdose caused by synthetic opioids — more than the single dose to reverse a heroin overdose.

Baltimore Fire Deputy Chief Mark Fletcher said first responders have found it takes “two doses or maybe even three doses” to restore respiration if a person used heroin laced with fentanyl or carfentanil.

It’s not yet clear how naloxone saturation is affecting overdose deaths overall. One 2017 study published by the National Bureau of Economic Research suggests that laws boosting naloxone access are linked to as much as an 11 percent drop in fatalities.

In a gritty Baltimore neighborhood, Shane Shortt, who is addicted to heroin, said he’s been able to revive five drug companions with Narcan over the past year and swears he never goes anyplace without an inhaler.

“You never know when you’re going to have to use it. It was actually used on me like last week,” Shortt said outside a Baltimore needle-exchange van where about a dozen people showing the ravages of long-term drug use lined up with a few younger people.

An addictions and recovery expert with the National Council for Behavioral Health, Tom Hill, said the bottom line is naloxone is just about “all we have” to battle overdoses.

“Anything to lower the costs of a life-saving drug is a very welcome thing,” he said from Washington.

Wen, who is among the many officials calling on the Trump administration to directly negotiate the price of naloxone with manufacturers, was more blunt: “We are in the middle of a national epidemic. We should not be priced out of the ability to save lives.”

Data Fix: Cities Seek Better Information on Opioid Epidemic

Paramedics and police are already in the hotel room when Kyle Simpson walks in.

“What happened?” he asks.

A 37-year-old man in the room is barely conscious–just revived by the overdose reversal medication NARCAN.

Law enforcement officers survey the scene. They’ve found more heroin “rocks” on a table. One officer interviews a crying woman who was with the man when he stopped breathing.

“He overdosed on heroin. He snorted it,” a paramedic responds.

Simpson is an Operations Major with Louisville Metro’s Emergency Medical Services. He says this won’t be the only scene like this tonight due to the opioid crisis.

“It has taken effect, and it has got a hold on this city.”

First responders like Simpson have learned a lot about how to deal with the epidemic. But he says he could use more data to better track overdoses.

“We could maybe establish patterns and maybe put an end to this.”

Tracking the Crisis

The Louisville Metro EMS is moving to new data tracking technology to make better use of the information they get from each overdose call.

“We need to know let the hospitals know that they’re going to be seeing an increase,” Public Information Officer Mitchel Burmeister said. “We need to make our EMS responders aware and our police and fire responders aware. And then we need to get the word out to the community.”

After a spike in overdoses earlier this year, federal officials approached LMES about adopting a program created by the Washington/Baltimore High Intensity Drug Trafficking Area.

The city previously tracked overdoses events with data pulled from multiple sources which wouldn’t provide immediate results.

The new program —provided at no cost to Louisville Metro– will have first responders enter accurate data into an easily navigated interface. That will update the agency’s private database in real time.

“We want to make sure that the data that we are collecting for this heroin epidemic is consistent and coordinated,” Burmeister said.

Louisville’s project is among a handful of efforts in the Ohio Valley aimed at filling surprising gaps in the information available about the scope and impact of the crisis. For all the attention the epidemic has received, timely, reliable data are often lacking.

A presidential commission on the opioid crisis includes a recommendation to improve data sharing in its interim report released this month, and health researchers are warning that a lack of good information could hinder the response to the crisis and lead to poor decision making.

Mind the Data Gap

Public health researchers have started to sound the alarm about impediments to information vital to their work to better understand the opioid epidemic and inform public policy decisions.

Researchers say federal funding cuts threaten some important national data sets and others are not being regularly updated. Some information sources kept by law enforcement agencies are not made available to researchers.

Dan Ciccarone with the University of California San Francisco has studied heroin use for nearly two decades. He said that in that time it has become more difficult for him to get law enforcement information on the type and nature of drugs agents have seized.

“We need some cross-pollination,” he said. “We need to get the information to other people.”

Law enforcement and public health researchers both want to find solutions to ending the opioid crisis. But they don’t speak the same language when it comes to their methods.

Ciccarone said enforcement agencies have the raw data researchers need to study things such as the potency and production of heroin. But the agencies tend to keep that information to themselves, perhaps out of concern that drug users or producers might exploit it.

“Maybe you don’t tell the users, then,” Ciccarone said. “Maybe you just tell emergency doctors. They might want to know if a new brand of fentanyl came in last week. All I’m saying is, we’re not doing enough.”

Other numbers gathered by state and county governments are often simply not timely or complete enough to keep up with the pace of a rapidly changing epidemic.

For example, data on overdose deaths in Kentucky, Ohio, and West Virginia are presented on different time periods and levels of detail. Overdose victims might be identified according to place of residence in one set of data, but by place of death in another. Different state agencies also follow different criteria for reporting information about the specific drugs involved in an overdose case. Such inconsistencies make it tough to get a full, regional picture of the toll the epidemic is having.

Insight into ODs

An innovative project in Cincinnati shows how better data can help.

The city’s Open Data Portal gathers data from various departments in order to track everything from government spending to trash pickup.

The city’s data department was also interested in overdose data in the local EMS logs. As part of the public Cincy Insights online project, Chief Data Specialist Brandon Crowley designed an interactive map that showed the overdose EMS calls by neighborhood while protecting private information.

“It makes sense that if we’re interested in looking at it, we’re sure the public would be interested in looking at it,” Crowley said.

As in Louisville, the idea first came after a dramatic series of overdose events in 2016. Originally, Crowley said, the city simply wanted citizens to see what was going on in their neighborhoods. But then local entities combating the opioid crisis took an interest in the data.

By tracking the times that overdose calls came in, first responders were able to look for patterns and anticipate when they need staff on hand. By tracking locations of the calls, the city hopes people who lead treatment programs will learn where their services are needed most.

“We recognize a visualization is not a panacea for this epidemic,” Crowley said. “But we realize that it can be used as a tool to help us lessen the number of events.”

The project has gained attention from outside Cincinnati as well, with other municipalities inquiring about how they could set up their own system.

Crowley said he believes that with the right technical knowledge and infrastructure, rural Appalachian communities can also develop similar inexpensive tracking systems.

The city hopes to add new data sets to the page. By teaming up with area hospitals and treatment centers, for example, they could track the outcomes of overdose events and the effectiveness of treatment.

Tracking Treatment

States are making efforts to fill in the data gaps as well.

West Virginia Gov. Jim Justice recently signed H.B. 2620, creating a state Drug Control Policy office.

Part of the office’s responsibilities will be to create a data repository in order to seamlessly share data among multiple state agencies.

“This will help us surpass a couple of the challenges that we have identified over the past few years in being able to both collect data in a uniform basis as well as then report it out in a timely and transparent manner,” State Health Officer Dr. Rahul Gupta said.

Dr. Gupta said data-driven work is important to making informed decisions regarding the opioid crisis.

Many agencies across the bureau are collecting different data sets related to understanding the problem. But Dr. Gupta would like to seem them more aggressively assimilate data related to prevention and treatment.

The agency recently did a study on a May, 2016, event in Huntington in which 26 people overdosed in the span of a few hours.

“What we found was, of these people that went to the hospital with an overdose, none of these people actually entered a treatment program,” Dr. Gupta said.

“What data will help us with is to be able to create programming for individuals that fits the needs of individuals.”

A Proactive Approach

Dan Ciccarone said this type of data will be essential to getting a well-rounded look at the opioid crisis.

For example, Ciccarone said, a new white powder version of heroin is coming from Mexico. But with researchers being denied access to data — like that from the old System to Retrieve Information from Drug Evidence or the new the National Seizure System — the public won’t know how deadly the substance could be.

“For all we know, that alone is dangerous.”

Without a better understanding of the drugs, Ciccarone believes the approach to the crisis will continue to be reactionary, rather than proactive.

Researchers writing in a 2015 white paper identified a dozen data sets that were severely lacking just regarding the use and abuse of prescription opioids. Those included information categories such as “Thwart Rate of Forgery and Doctor Shopping Attempts” and “Prevalence of Drug-Seeking Behaviors.”

The authors of the white paper called on a “variety of sources, including federal agencies, proprietary systems, national organizations, academic institutions, industry, and state and regional government agencies” to step up their efforts to collect much needed data.

The new information systems in cities like Louisville and Cincinnati won’t fill every gap, but here in ground zero of the nation’s opioid crisis, every bit of data helps.

ReSource member station WFPL reporter Jacob Ryan contributed reporting for this story.

Should Public Schools Stock Naloxone?

In September the West Virginia State Board of Education approved a new policy that will allow schools across the state to stock intranasal naloxone or narcan to help deal with overdoses. Starting yesterday school boards can now enact policy changes that will allow them to carry the drugs in their schools. As part of the new policy only school nurses with a RN or LPN license can administer the life-saving drug that reverses the effect of opiates in an overdose situation.

While the rest of the state is considering whether or not to adopt the policy, Cabell and Brooke counties have already been stocking the drug. Last spring the Cabell-Huntington Health department approached Cabell County Schools with the idea of supplying them with narcan. The school got a waiver approved by the State Board of Education. Misty Cooper is a school nurse at Huntington High School in Cabell County who says it made sense to start stocking the drug.

“If you don’t have that medicine to even try, no amount of CPR we can do is going to take that opioid out of their system, narcan will get it out and help them start breathing and all that, but if we don’t have it, we’re very limited,” Cooper said.

The drug is the one paramedics and health officials are using. It’s administered through the nose during an overdose.

Cabell County isn’t the first county in the state to receive the waiver allowing them to stock the overdose antidote. Brooke County, which suffers its own problems with heroin and opiate use, stocked it earlier last school year. In November Carol Cipoletti, the school nurse coordinator and school nurse at Brooke County High got the ball rolling. By the spring Brooke County was stocking the drug. In Cipoletti’s twenty-two years she’s had to resuscitate two students from opiate overdoses.

“And with the community heading in the direction it is with a lot of opiate overdoses going on, a lot of heroin traffic going through the area we just hope we don’t see it again, but I want to have something here just in case,” Cipoletti said.

In Brooke County they’re stocking the drug in the middle and high schools. In Cabell County they’re stocking it in, middle schools, high schools and even elementary schools. Todd Alexander is the Assistant Superintendent for Cabell County Schools and he says they want the drug in elementary schools because it’s not just for the students.

“We’ve also had some isolated cases where parents arrive at the school and have been under the influence of substances to the point that schools have contacted law enforcement because the parents were coming to the school to check their kids out of school,” Alexander said.

It’s incidences like these that present another question of administering naloxone in public schools. Should more than the nurse able to use the drug? Huntington High Schools school nurse Misty Cooper says yes.

Personally I think there should be more than me,” Cooper said. “I cover the alternative school and the career center. If someone od’s at the career center and I’m not there, who’s going to give it.”

C.K Babcock is a Professor at the Marshall University Pharmacy School and trains officials and the public on administering naloxone or narcan at the Cabell-Huntington Health Department. He says an overdose incident can happen at any time, such as an athletic event at night and a nurse may not be present. He says EMS may be on hand, but it never hurts to have the drug available for use in as many people at the school as possible.

"The faster you get it the more chance you have of saving them." — C.K. Babcock, Marshall University School of Pharmacy

“It needs to be on site, it needs to be in someone’s hand and easily accessible and speed is the answer,” Babcock said. “The faster you get it the more chance you have of saving them.”

According to the state board of education, if counties choose to adopt a policy for stocking naloxone, they will have to purchase the medication out of their county budget unless a community partner provides funding. Brooke County obtains the drug from Brooke County EMS. Cabell County has obtained the drug through the Cabell-Huntington Health Department.

The United States Senate encourages the use of grant programs like the Substance Abuse Block Grant funds to obtain naloxone.

W.Va., Ky. Schools Stocking Drug to Reverse Opioid Overdoses

The West Virginia Board of Education approved a policy last week allowing county school systems across the state to start stocking Naloxone—a medicine that reverses the effects of a drug overdose—in schools.

Two counties—Brooke and Cabell—were previously allowed to keep the overdose antidote in schools, but the new policy expands the program statewide.

In Kentucky, similar efforts are underway with Narcan, which is very similar to Naloxone and used for the same purpose. Bowling Green Superintendent Gary Fields said educators across the state are being trained to administer Narcan this week.

“I think any time we ask lay people who aren’t health care professionals to administer medicine, that’s always a scary moment, but if we feel like it’s going to possibly save the life of a student down the road, then I think we’re going to have to move in that direction,” Fields told member station WKYU.

While several Kentucky school leaders are being trained to administer Narcan there, in West Virginia, the new Naloxone policy says only schools nurses can administer the antidote which comes in the form of a nasal spray.

There are about 415 nurses covering more than 700 schools in West Virginia.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.