Guest Op-ed: Opiad Overdoses and Deaths Are on the Rise

With another news article nearly every day, the general public is becoming more aware of a health epidemic that public safety and medical staffs have known for long time: opioid overdose and deaths are on the rise.

The deaths of Philip Seymour Hoffman and Cory Monteith have brought national attention to the opioid overdose epidemic. Locally, police, EMS and ER staffs have struggled to save an increasing number of overdose victims. In fact, the Boston area has the highest rate of emergency room use for opioids overdoses in the country.

In Charlestown, the Charlestown Substance Abuse Coalition (CSAC) has been working to prevent and reduce opioid overdose deaths for more than a decade. CSAC is a community-based coalition of residents, businesses, organizations, professionals, and advocates who work together to prevent and reduce substance use and addiction in Charlestown. CSAC, supported by the MGH Center for Community Health Improvement, uses existing community resources, organizes programs to identify needs, and harnesses the energy and commitment of the community toward their goal of providing a safe, healthy environment for everyone in Charlestown.

CSAC is committed to working on all aspects of substance use from prevention to treatment. Most visible education and awareness efforts include the youth driven Turn it Around Campaign that can be seen throughout the community and in local bus shelters (www.turnitaroundcharlestown/ and prescription drug Take Back Days done annually during open market in June. Evidenced-based Prevention Curricula is delivered to students at the Warren Prescott and Edwards middle schools by local residents and community providers. CSAC also helps individuals identify and connect with addiction treatment options. The coalition was instrumental in developing Charlestown’s first Drug Court, which is court-stipulated addiction treatment, intensive court supervision, mandatory drug testing, and other social services as an alternative to incarceration.

When asked about recent overdoses in the media, CSAC director Sarah Coughlin described the importance of not only preventing use, but also saving lives by providing broad access to a medication called Narcan. Narcan, also called naloxone, is a safe and effective medication to reverse the effects of an opioid overdose. Administered as a nasal spray, it acts in the brain to reverse the effects of opioid drugs, like Percocet, Oxycontin, or heroin. In the case of an overdose, Narcan restores normal breathing. It is a non-addictive prescription medication that works if a person has opioids in her system; the medication has no effect if opioids are absent.

Coughlin said the coalition has been vigorously advocating for all emergency personnel to carry Narcan for several years. All Boston EMS paramedics and EMTs carry Narcan, however the police and fire are often the first responders to an emergency call.  Communities surrounding Boston allow their fire department personnel to use Narcan to reverse drug overdoses, and this has saved lives. Thanks to advocacy from the Revere CARES coalition and the city of Revere, and with support from a state DPH grant, the Revere Fire Department has carried Narcan to emergency calls since February 2011. To date, Revere has used Narcan 113 times, reversing 105 overdoses. Fire departments nearby in Saugus and Chelsea hope to soon do the same.

A recent example of the need for Narcan came this past January when Janet McLaughlin and her daughter Kaleigh Shea, with help from a 911 operator, delivered lifesaving CPR on a man who overdosed in a donut shop bathroom. When the Boston Fire Department arrived, as first responders, they did not have Narcan, and those at the scene were asked if anyone had it to administer.

This month, Boston Mayor Marty Walsh called for police officers and firefighters to carry Narcan. In addition, the Boston Public Health Commission, which distributes Narcan in Boston, will host five community workshops in February in South Boston, East Boston, the South End, Dorchester, and Allston-Brighton. Residents who attend the workshops will receive overdose prevention training, an overview of treatment options, information on how to access Narcan, and an opportunity to meet with the neighborhood substance abuse coalitions. Each Narcan kit costs $20, and a two-dose kit is given free-of-charge to anyone who completes a one-hour Narcan training course offered by the BPHC.

Dr. Sarah Wakeman, Medical Director for Substance Use Disorders at MGH CCHI and a physician at the Charlestown Health Center, believes broad Narcan distribution is a crucial and lifesaving public health intervention. But she cautions, “We must remember that opioid overdoses are a symptom of the underlying disease, which is opioid addiction. To truly stop the overdose deaths, patients need access to more quality, evidence-based treatment options, including medications like buprenorphine, methadone, and naltrexone which are among the most evidence-based tools we have to treat opioid addiction. In addition, we must continue efforts to decrease the stigma of addiction, which is one of the main reasons people do not seek treatment.”

CSAC applauds Mayor Walsh, and hopes that his proposal will be swiftly adopted so that Narcan becomes widely available to trained residents and all first responders in Boston to prevent the next fatal opioid overdose. In addition, CSAC hopes the sense of urgency generated by this tide of deaths will strengthen ongoing efforts to increase access to effective addiction treatment.

The Charlestown Substance Abuse Coalition is community based coalition of residents’ businesses, organizations, professionals and advocates who work together to reduce substance abuse in Charletown.

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