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Tim Ludwig
Dr. Skutar
Intermediate Comp 2089
March 4, 2014
Proposal
My presentation is intended to address the debate of how to approach a reasonable
solution to the prevention of overdose cases in our region. In recent years first responders
have been responding to overdose patients at a record pace. Currently there is a debate on
a possible solution to the death toll that inevitably accompanies such cases. Unfortunately,
there is not a clear solution. This presentation will discuss ways to prevent death by
overdose by use of a medication called Narcan®. It is used to reverse the effects of opiates.
Specifically, it is the primary medication that is provided to individuals who are suspected
to have overdosed from an opiate, and more accurately who may have overdosed from
heroin.
One side of the debate will push reasons for Narcan® to be administered to friends
and families of addicts, and in some instances the patient themselves. The argument is that
information could be taught, and proper techniques could be provided to friends and family
to administer the medication in case of an overdose. There are even certain laws that have
been enacted around the country that will not allow for legal action from and police that
respond to the scene as well as paramedics, and other fire department personnel. The idea
is that through this type of education and back up, the death rates will decrease. This is a
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similar comparison to the making the Epi-Pen® available to those who suffer from severe
allergic reaction from bee stings, and shell fish. (Anaphylaxis)
The argument against this approach is that the medical community, and government
is enabling the addicts to continue with their current behavior, and perhaps even
encouraging additional experimentation. I feel that the obvious argument is that those who
require an Epi-Pen® do not choose to have those types of reactions and therefore is a
reasonable medication that can and should be made readily available. The same could be
said for Aspirin to be taken at the first sign of a heart attack or simply prophylactically
taking the medicine to lessen the likelihood of a cardiac event. By allowing friends and
family or the patient themselves to have Narcan® we are basically telling them that they
are on their own, we do not care for there treatment and long term care.
I will address other alternatives to the prevention of drug overdose by way of heroin
and other narcotics. Primarily through education of care providers as well as patients. I feel
that a new outlook on pain management needs to be explored as well as more follow up
with pain management programs. I will discuss in further detail reasons and proof from
statistics that make argument for both sides of this debate, however, making my best case
for alternate options and not to allow Narcan® to be held by friends and family or patients.
By doing so, we would not be addressing the primary issue which is to cease the use
altogether instead of sweeping in under the rug for someone else to worry about later.
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Abstract
This presentation reviews the discussion on allowing heroin addicts/patients to
have front line medication to reverse the effects of narcotic overdoses as a way to prevent
the increasing death totals of such occurrences. This presentation identifies that while
there are studies that will show evidence that this preventative measure could be useful,
that ultimately it will create bigger issues, and that it is not helping to prevent overdose
from happening, but it more accurately prevents those overdose cases from just being
reported to authorities.
This presentation takes an honest approach based on statistical studies and first
hand experiences as a first responder to such cases. It is the presenters intention to argue
against the allowance of medications such as Narcan® to be utilized by friends, family or
patients themselves. This presentation will instead discredit any evidence of such studies
that advocate this “preventative” technique and instead will provide possible alternatives
in the prevention of overdose, as well as the treatment of pain patients.
Throughout the presentation, information on the medication (Narcan®) will be
provided. A review of overdose signs and symptoms including an etiology of how/why they
may occur so frequently in today’s society. Finally, the presentation will discuss the
argument of why not to allow such medications to be utilized and why it is so important to
this presenter and the public from a personal and professional point of view.
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Evaluative Annotated Bibliography
1.) Williams, Anna V. Marsden, Strang. “Training Familiy Members to Mange Heroin
Overdose and Administer Naloxone: Randomized Trial of Effects on Knowledge and
Attitudes.” Addiction (Abingdon, England) 109.2 (2014) 250-9. Web.
2.) Coleman, Andrew P. “Cost-Effectiveness of Distributing Naloxone to Heroin Users for
Lay Overdose Reversal.” The Journal of Emrgency Medicine 44.5 (2013) 1057. Web
3.) Jones, Jermain D. Et al. “Brief Overdose Education Can Significantly Increase Accurate
Recognition of Opioid Overdose among Herioin Users.” The International Journal on
Drug policy 25.1 (2014) 166 Web.
4.) Rastegar, Darius A., Walley.A, “Preventing Prescription Opioid Overdose Deaths” Journal
of General Internal Medicine 28-10-2013; 1258-9. Web
5.) Bennett, Trevor; K. Holloway, S.Bird, “Does Take-Home Naloxone Reduce Non-Fatal
Overdose?” Lancet 383.9912 (2014): 124-5. Web
6.) Ling W, LT Wu, “Prescription Drug Overdose: Between Patients and Their Doctors.”
Substance ASbuse and Rehabilitation 2013. Web
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7.) Wheeler, Eliza “Community-Based Opioid Overdose Prevention Programs Providing
Naloxone – Untied States, 2010.” JAMA, The Journal of the American Medical
Association 207.12 (2012) 1358. Web
8.) Kuehn, Bridget M. “Methadone Overdose Deaths Rise with Increased Prescribing for
Pain.” Journal of the American Medical Association, sec 308: 749 (2012) Web
9.) Bohnert, Amy S., M.Tracy, S. Galea. “Characteristics of Drug Users Who Witness Many
Overdoses: Implications for Overdose Prevention.” Drug and Alcohol Dependence
120 1-3-2012. P168-173.Web
10.) Sherman, Susan G. “Efforts to Reduce Overdose Deaths.” American Journal of Public
Health 103.8 2013. Web
11.) Banta-Green, Caleb J “Police Officers and Paramedics Experiences with Overdose and
Their Knowledge and Opinions of Washington State’s Drug Overdose-NaloxoneGood Samaritan Law.” Journal of Urban Heatlh” bulletin of the New York Academy of
Medicine 90.6 (2013); p1102-1011. Web.
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