Executive Summary
As the nation continues to reel from the opioid epidemic, efforts are being made in Bucks County, Pennsylvania to help to reduce the number of fatal overdoses by increasing access to the life-saving rescue medication, Naloxone or Narcan. Since, 2014 the Bucks County Drug & Alcohol Commission, Inc. (BCDAC), the Single County Authority in Bucks County, has helped to fund the purchase, dissemination, and training of Narcan Nasal Spray to law enforcement, schools, professionals, and families throughout Bucks County.
History of Naloxone Access in Pennsylvania
In 2014, the state of Pennsylvania took steps to widen the access of Naloxone. Naloxone or the more commonly referred to by its brand name, Narcan, is the life-saving medication that reverses an opiate overdose. As the number of overdoses began to rise across the state of Pennsylvania, the need for this life-saving medication increased. The passing of Act 139, or the Good Samaritan Law, which included immunities to individuals calling for help and acting in good faith to prevent a fatal overdose by cooperating with first responders, also provided changes to how Naloxone could be administered. Act 139 increased the access and use of Naloxone to include first responders and the lay person. In 2015, the Physician General, Dr. Rachel Levine, signed into effect a standing order in Pennsylvania. This standing order allowed for all Pennsylvanians to obtain Naloxone without a prescription. The state created the legislative means to widen the access to Naloxone, and BCDAC began to create a plan to ensure Bucks County residents would be able to get their hands on this life-saving medication.
Narcan Distribution Efforts
The Bucks County Drug and Alcohol Commission, Inc. offers a multi-pronged approach that requires collaboration with all systems to provide a balanced continuum of quality prevention, intervention treatment, and recovery services in Bucks County. All components are essential to the fight against the opioid epidemic, but more immediate efforts need to be put in place to help save lives. As part of the first action step, in partnership with the Bucks County District Attorney’s office, BCDAC has helped to equip police departments with Narcan Nasal spray, and as of 2017, there is 100 percent police coverage of Narcan in Bucks County. Since 2014 law enforcement have reported close to 400 lives saved with Narcan. First responders are not the only ones who need to be equipped with Narcan, BCDAC has worked to provide training and funding doses of Narcan Nasal spray to area treatment providers, agencies, and Bucks County employees. To further serve the recovery community BCDAC expanded access to recovery residences. Bucks County is home to a multitude of recovery residences. In an effort to create some standardization and guidelines, the Bucks County Recovery House Association was created. BCDAC supports members of the Recovery House Association and also recognizes the need for Narcan in these recovery residences. Doses of Narcan were provided to all recovery residences in the Association and training was provided to all staff. BCDAC continues to provide doses of Narcan to recovery residences and provides replacement doses if needed.
Narcan distribution is just one part of the equation, BCDAC provides all recipients of Narcan with resources and training. In addition to training, BCDAC requires all agencies, entities, schools, and recovery residences to submit a policy in order to receive doses of Narcan. The policy outlines how staff will be trained on an ongoing basis, how the Narcan will be properly stored, and outline an aftercare plan or protocol. BCDAC also requires notice within one business day of the use of Narcan, a Narcan Utilization Questionnaire, essentially an incident report, must be submitted allowing for a replacement dose to be issued.
Equipping Bucks County Residents to Save Lives
While BCDCAC increased Narcan access to professionals, agencies, schools, and recovery residences, it became even clearer that BCDAC needed to continue to provide education to residents on what is Narcan, where to go and how to purchase it, and bring community trainings to the residents of Bucks County. During the past year, BCDAC helped to coordinate and provide Narcan doses at 10 community trainings held throughout Bucks County. Approximately 390 participants were trained on the topics of opioids/opiates, opioid/opiates addiction, Narcan, how to respond to an overdose, and how to administer Narcan Nasal Spray.
The number of fatal overdose deaths continues to plague communities, and in many areas, continues to rise. At the end of 2016 BCDAC decided to ramp up Narcan distribution. Since December 2016, Bucks County residents have the opportunity to come to the BCDAC office to meet with staff, watch a brief instructional video and learn more about resources in Bucks County, and ask any questions. Since the start of this initiative we have served more than 100 residents, and we know that residents have had to use their doses from our office to save the life of a loved one. Some of the most frequently mentioned reasons as to why a person is seeking to obtain Narcan includes concern about a loved one in the active stages of addiction, or family members want to be prepared because a loved one has recently returned home from incarceration or treatment. Some residents want Narcan just because they are aware of the widespread reach of this epidemic and they want to be prepared -- for any situation.
Looking Ahead
As we look ahead, one of BCDAC’s goals will be to continue to be able to provide this life-saving medication to Bucks County professionals and residents. BCDAC recognizes that Narcan is just one tool in the fight to address the immediate need, but that alone, Narcan is not enough. Quality evidence-based prevention education efforts, awareness, access to treatment, and recovery supports are all vital and collectively may yield solutions to this epidemic. BCDAC will continue to support initiatives and efforts in Bucks County that provide education, inspire messages of hope, and help to destigmatize the disease of addiction.